Do not inflate the bladder to a pressure greater than 200 mm Hg. If the
pulse can still be heard at 200 mm Hg, deflate the bladder (unscrew the
valve) and remove the bladder from around the patient's arm or thigh.
Then notify your supervisor of the problem.
o. Listen for Pulse. Once you have inflated the bladder to the desired pressure
(140 mm Hg or higher, depending upon when the pulse disappeared) listen briefly to
make sure that you cannot hear the pulse beat below the bladder.
(1) If you cannot hear the pulse, then the air pressure inside the bladder is
greater than the systolic pressure of the blood. (The bladder is, in effect, now a
tourniquet.) You are now ready to begin releasing the air from the bladder.
(2) If the pulse can still be heard, inflate the bladder until the pulse
disappears, then inflate it an extra 10 mm Hg of pressure. Do not inflate above 200 mm
p. Release Air Slowly. Watch the gauge closely and listen through the
stethoscope as you release air from the bladder. Air is released from the bladder by
rotating the release valve (screw) counterclockwise (figure 5-10). The more the screw
is turned, the larger the opening and the faster the air escapes. You want the air to
escape slowly enough so that you can tell at what pressure reading the pulse
reappears, but fast enough that the continued pressure does not harm the patient or
cause unnecessary discomfort.
Figure 5-10. Rotating the screw counterclockwise to release pressure.