Blood pressure by auscultation is assessed in the right arm by inflating the cuff to about 20 mm Hg above the systolic pressure that was determined by palpation. The diaphragm of the stethoscope should be placed over the artery as close to the edge of the cuff as possible, preferably just under the edge. The cuff is deflated slowly while the Korotkoff sounds are evaluated. The systolic blood pressure, the point of muffling, and the point of disappearance are determined. The systolic blood pressure is the point at which the initial tapping sounds are heard. The technique of determining auscultatory blood pressure is shown in Figure 14-21. If the blood pressure is high, it is useful to measure the blood pressure again at the end of the examination, when the patient may be calmer.
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