Blood pressure (BP) measurement is one of the vital signs used in assessing patients. It is the pressure exerted by circulating blood on the arterial vessel walls. It is often very useful in determining a patient's clinical condition. For example, a hypotensive patient may be septic from an infection or it may be due to volume depletion due to dehydration or blood loss. Along with other vital signs blood pressure monitoring is one of the cornerstones used in assessing a patient's clinical condition. In this OSCE station it is important to a good knowledge and understanding of what the blood pressure readings indicate as well as correct technique to get accurate measurements.
Wash your hands using the Ayliffe technique
Introduce yourself and give your name and grade
“Hi, my name is Jack Cobb and I am a 4th year medical student”
Clarify patient's identity by confirming name and asking for their DOB
Explain what you will be performing and what it involves
“I have been asked to measure your blood pressure today. This involves placing a cuff around your arm and listening to your pulse with a stethoscope. It may be a little uncomfortable while the cuff is inflated but should not be painful.”
“Would this be ok with you?”
Initial estimate of systolic blood pressure:
Let the patient know you have finished examining them and thank them for their time.
“That’s the end of the procedure. Thank you for your time?”
Ensure that you have documented the patient’s blood pressure.
If there are any abnormalities in the blood pressure (hypertensive/hypotensive) repeat on the opposite arm after a few minutes.
If still hypertensive explain next steps ‐ home BP monitoring/antihypertensive. Summarise key points to the patient.