Improper cuff width or length is one of the primary sources of error in accurately assessing blood pressure. Experts recommend using a cuff with a bladder width that is 40 percent of the measured upper-arm circumference. Undercuffing occurs when the bladder is too small, leading to overestimation of blood pressure; similarly, overcuffing is when the bladder is too large, leading to underestimation of blood pressure. Accurate measurement for blood pressure cuff sizing helps providers obtain consistent, relevant diagnostic information on blood pressure.
Step 1
Rest the individual's arm on a table or your shoulder so that the middle of the arm is at the level of the heart.
Step 2
Estimate the individual's arm circumference or measure it at the midpoint between the acromion process, or the highest point of the shoulder, and the olecranon process, or the bony landmark of the elbow. Choose a cuff size from the four sizes commercially available: children, standard adult, large adult and obese.
Step 3
Wrap the deflated cuff firmly around the upper arm so that the midline of the cuff is over the brachial artery pulse. The lower edge of the cuff should be 2.5 cm above the antecubital fossa, the depression on the front of the elbow.
Tips and Warnings
- The bladder of the cuff should encircle 80 percent of an adult's arm and 100 percent of a child's arm.
- Avoid placing the cuff over clothing; if the shirt sleeve is rolled up, make certain that it is not blocking the circulation.
References
- "Advanced Fitness Assessment and Exercise Prescription"; Vivian H. Heyward, PhD.; 2006
- MayoClinic.com: Get The Most Out of Home Blood Pressure Monitoring
