Blood pressure

Most of my doctors use automatic wrist cuffs and ask me to raise my sleeve if wearing long-sleeved shirts.

As an internist I ALWAYS checked my patients BP myself. Bare arm essential. Patient has had a few minutes to rest, both feet on the floor. Listen to the Korotkoff sounds. Most accurate way to do it in the office. It also gave me a minute to touch the patient and pay total attention to him or her. It just takes a minute and was time well spent. Just like listening to the heart and lungs on bare skin. I learned physical diagnosis the old fashioned way.

As an internist II learned physical diagnosis the old fashioned way.

We teach it the old fashioned way but local standards and time pressures immediately destroy the good habits.

I use my Welch Allyn ProBP 2400 at home. My physician also uses an electronic sphyg. I never paid much attention to which one because he has a few different ones. I don't recall having a manual sphyg used for many years. In my experience, they only use a manual after an electronic if the patient questions the electronic reading, saying it was unusual for them, which usually meant high.

At my OB office the nurse always checks it manually. My doctor has checked it himself twice. Once when the nurse was doing something else and he was able to come see me before she got to me. He just pulled a cuff out of the drawer and took it. One time the nurse got an elevated reading so she told me to lay on my side for a bit. When he came in, he took it himself and it was normal.

For my BP measurement my doctor uses a manual cuff when am wearing a long sleeve clothing i pull upnthe sleeve my self never the doctor

My doctor uses a manual cuff and stethoscope. I role up my own sleeves. Now and then he will go u see my clothes.

At my work place Hypertension CLinic at Columbia University medical center l almost always use either a mercury or a aneroid device. Whenever I take my own pressure l use a palm aneroid with a ADC Adcuff with a Littman cardiology stethoscope.

I take readings in both my arms lying down seated and standing.

Last night my pressure without medication was severely elevated at 240/190.

I hope you're not often without your meds!

My doctor uses a B/P cuff and stethoscope. I pull up my own sleeves or sometimes they will smooth it out and take it over my clothes.

Most of the doctors I see, use a manual b/p cuff. I think usually, I pull my sleeve up or like right now (Summer in the South) nothing is in the way because I am only wearing tank tops and not t-shirts. If in the winter my sleeves are in the way, I just pull them up.

My doctor uses the manual. I push my own sleeve up. The hospital clinics and wards here use the automatic, it's on a cart they wheel around and the oximeter is hooked up to the machine, too.

30 years ago, my then GP had an automatic she had just got and she tested that against the manual and the readings were not the same, so she stuck with the manual.

My doctor has the manual ones that the nurse uses. He has even had me bring in my automatic one and do both of them to see if mine is accurate. There is usually some difference but not much. I have been told that doing it manually with a stethoscope is the most accurate way there is.

Automatic - although I think most have a manual as a back up to double check an auto reading.

I had the pleasure of doing a blood pressure check on local news caster Michelle Charlesworth live on the morning news. I used both a manual and a digital device when taking her pressure. Her pressures where measured simultaneously in both arms. Her pressures were surprisingly elevated 166/100 and 169/105. Later on back in her dressing room l rechecked her pressures with the manual Sphygmo. Her pressures came down slightly to 140/86.

Automatic, and usually the nurse rolls up my sleeve.

Automatic I typically roll my own sleeve up. Has anybody every fkexed and blown the balloon up on the nurse or doctor? I have it’s scares the heck out of the but I have done that to them in a few years.

I have high blood pressure so I get checked pretty often. My regular doctor has an automatic machine, but the cardiologist's office does it manually. I actually enjoy that more, because I like the way they will hold your arm while pumping up the cuff.

My doctor always uses a wall mounted Baumanometer and a Baum cuff whenever she takes my pressures. If not wearing short sleeves she usually has me remove by top. My gynecologist uses both a Dinamap and a aneroid gauge. My pressures always higher when taken with the Dinamap.

Where i work doctors prefer a manual one. My primary doctor does manual but my gyno uses a electronic one on a little cart they wheel room to room.

Automatic for me now (over my sleeve, unless I’m undressed for some other reason) and I hate that thing. Goes WAY too tight!

Automatic for me now (over my sleeve...

Can any of the professional medics (@bpdoc perhaps???) confirm if this is common practice? I thought the guidelines were to always place the cuff on bare skin? Or does expediency trump a possible small loss of accuracy in the real world?

Goes WAY too tight!

I know what you mean. I usually get the dreaded 'double pump' where it inflates, then because I'm anxious and my BP is up, it inflates some more. It's a feedback loop that does my BP no favours!

In our surgery all the Doctors' rooms have big square wall mounted aneroids, either Welch Allyn 767s or Riester Big Bens. The practice nurse has an Omron M7 automatic in her room.

I usually get the dreaded 'double pump' where it inflates, then because I'm anxious and my BP is up, it inflates some more. It's a feedback loop that does my BP no favours!

@DinaMapper I'm all too familiar with this scenario...Always happens without fail in a clinical situation. Also, with someone new taking my blood pressure and not familiar with my White Coat Phenomenon, often times, while measuring pressure with a manual cuff, I experience a sort of "double pump." Examiner places stethoscope to my skin and initiates inflation of cuff. Hits 140, 160, wherever that normally cease inflation with any normotensive subject. Examiner will immediately hear the thud of my pulse under the cuff. This results in a quick burst of air, taking the cuff pressure on up, high enough to finally occlude the artery. Such a pain in the ass, this White Coat Syndrome.

Here recently, I've been hitting the pharmacy and grocery store machines just for giggles. Try and knock some of the anxiety out of regular clinic measurement anyway...Thinking the exposure might help. It hasn't in the least, but I kind of get a rush out of that nervous feeling one gets in their chest as the cuff is applied. Anyway, point being, Even with self measurement at an automatic unit, most times I get the double pump in this capacity as well. I make myself nervous. A lot of it, weird as this sounds, I think, is due to being in a public location.

At home, taking my blood pressure, first measurement especially, my blood pressure is elevated from normal. Never quiet like it is at pharmacy or other retail location though. With successive BP determinations, my SBP and DBP continue to drop. As does HR.

Always happens without fail in a clinical situation.

I've don't recall having the 'double pump experience' with a manual that you describe, mainly because I've successfully avoided having it checked in clinical settings recently.

I tried the desensitising thing at the pharmacy a few years ago. We tend not to have the kind of automated sit in booth type things that are commonplace in just about every pharmacy in the US and Canada. Over here you can ask in the pharmacy and they'll take you into a consultation room and check your pressure, invariably with an automatic machine. Some of them will just check it and tell you what it is and whether you should see your GP but others will give you a form asking everything from name, address, DOB, shoe size to how many times a week you eat oily fish. It became a pain in the ass, just check my pressure and I'll be off, thanks!

It certainly didn't work for me either. I'd be sitting there trying to breathe calmly and would feel quite chilled, then the cuff would get strapped on and I'd feel the kick of adrenaline and the increased thudding in my chest, closely followed by the 'double pump of dread' and a note to take to my GP.

At home, taking my blood pressure, first measurement especially, my blood pressure is elevated from normal. Never quiet like it is at pharmacy or other retail location though. With successive BP determinations, my SBP and DBP continue to drop. As does HR.

Exactly the same for me.

All of the avoidance above might sound like I'm negligent of my health...I don't think I am. My readings at home are pretty much normal except when I'm playing. I also get regular eye checks so I figure if my BP was permanently high it would show on ophthalmoscopy. Obviously that would only be evident after damage has occurred but I'm content that I'm seen regularly enough and by someone very competent with an ophthalmoscope that any change would be noted.

Such a pain in the ass, this White Coat Syndrome.

I couldn’t agree more. A case in point was earlier in the year when I broke my leg. I got referred to orthopaedics and while I was waiting for the doc to call me another patient came out of one of the consultation rooms with a doctor who said, "If you could go in there the nurses will check your blood pressure and ask you a few questions." Evidently she needed surgery for whatever injury she had so this was obviously a kind of pre-op check. The door to the room she was directed to was open when I arrived and I'd seen the BP monitor on the stand. There was also a printed A4 sheet of paper on the wall beside the monitor. It said something along the lines of "Any BPs greater than 160/100 to be referred to….”, I couldn’t make out the rest. Thing was, the door was left open when she was in! They sit her down, cuff on, pressure checked, all pretty much in front of the four or five of us in the waiting room. Normally that sort of scene would be manna from heaven for me but all I could think was, “FUUUUCK!!!! That’s gonna be me sitting there shortly….they’ll check my BP in front of the whole waiting room….it would be high even without the audience so no doubt it’ll be sky high…they’ll refer me back to my GP to get it under control before they even consider surgery….”. So many rabbits running in my head.

Thankfully when I got called to see the doc he said that the fracture I had would heal naturally in 99.9% of cases so, all being well, no surgery for pins or plates would be needed. I was free to go and enjoy the unseasonably warm sunshine. Stupid as it sounds, I was just relieved they wouldn’t be checking my BP.

Over the years I’ve even considered stuff like hypnotherapy to de-program me from this reaction but have never followed it up. I think that’s mainly because on the other side of the coin it’s such an enmeshed part of my sexual side that I’m worried I’d lose my mojo. It’s a bit of a Gordian Knot that I haven’t found the frayed loophole for.

My pressures is taken with both types of bp devices. My hypertension specialist used a Microlife dual arm unit that took readings in both of my arms simultaneously. I was so aroused that my systolic was sky high at 244 left arm and 278 right arm. I had just taken some ephedra which caused the severe elevation. I use a Baum mercury at home.

At my doctors office they take BP manually. If I am wearing normal clothes I usually remove my sweatshirt and have a tshirt underneath.

Once a year visit ... my cardiologist always uses the manual blood pressure cuff. It is the only time that my blood pressure is taken in both arms. After the routine "small talk," the doctor always instructs me to strip from the waist up and to remove my shoes and socks as well. He takes my temperature first, followed by the BP check. This is always followed by the recording of a computerized 12 lead electrocardiogram. After the EKG, my carotid arteries, chest, and back are thoroughly auscultated while I sit on the exam table. I am then instructed to position myself flat on my back for continued auscultation and the percussion of my chest. I then lower my pants to mid-thigh in order for the palpation and auscultation of my femoral arteries. He always lowers each side of my underwear for the femoral pulse checks while keeping my genitals somewhat vulnerable but always covered. It is the femoral checks that always have me somewhat aroused knowing that the stethoscope is placed into my pubic hair ... and, knowing that my pubic hair is on full display for the doctor. His exam procedures are always clockwork with an echocardiogram done every other year. Since chest, and body, auscultation is a huge turn on to me, I look forward to my yearly visit. Another bonus is that my cardio doctor is always hands on when examining me. The only thing that his nurse does is to call my name and direct me to the selected exam room.

My doc has the manual one with stethoscope. I had my artery removed from one arm for a bypass so I direct them to the other arm.

My physician always uses a Baumanmometer mercury column with a Baum cuff. Because I am hypertensive, he usually takes my pressure in both arms lying down, sitting and standing. Never taken over clothing.

@yachtie

Good Day and Hello,

1) It depends on which doctor I go to. My family doctor still measures blood pressure the "old" way, with a manual measuring device and a stethoscope. With that she achieved quite good values for me.

If I go to a specialist (cardiologist, etc.), an electrical measuring device is used there. Unfortunately, it often doesn't come across as well, because the values are increased or the measuring device makes an incorrect measurement when I have cardiac arrhythmias.

In the many hospitals I've been to, measurements are only taken with the electrical measuring devices, or you are wired directly to a patient monitoring monitor.

2) No matter where or to which doctor, I also go, before the examinations I have to take off my clothes down to my underwear. You stand almost "naked" in front of the doctor and are examined in the examination room. Even in the hospital, I had to at least undress so that you could be reached and examined.

Best regards