4-21. PRINCIPLES RELATED TO OBTAINING THE BLOOD PRESSURE
a. The patient's arm must be at the level of the heart. If the arm is below the heart,
false elevated pressures are obtained. If the arm is above the heart, false lowered blood
pressures are obtained.
b. The arm should be supported during the entire procedure to prevent elevation
due to muscle contractions used to maintain the position.
c. The cuff and stethoscope should be placed directly on the skin. Light pressure
should be applied when placing the stethoscope over the artery.
d. The cuff should be quickly deflated to zero, once the last measurement is heard.
Wait a minimum of 30 seconds before measuring the blood pressure again.
4-22. THE GRAPHIC SHEET
a. A graphic sheet is maintained so that all vital sign readings are easily accessible
to members of the health care team. Each reading is recorded as a dot in the proper
space, with lines connecting the dots. Readings throughout the patient's illness are
indicated across the page in unbroken lines. The form used to graphically record the
patient's vital signs in a United States (US) Army hospital is SF 511, Clinical Record--Vital
b. Recording data.
Enter the patient's identification data in the space at the bottom of the
(2) Number the "Hospital Day" line of blocks with the day of admission as one,
and continue consecutively. Use the "Post-op Day" line as applicable. The day of surgery
is the operative day. The day following surgery is noted as the first post-operative day.
Label the day/hour blocks properly.
(4) Represent temperature by dots placed between the columns and rows,
and joined by straight lines. If the temperature is other than oral, indicate so by (R) for
rectal or (A) for axillary.
Show pulse by use of a circle connected by straight lines.
(6) Enter the respiration and blood pressure on the indicated rows below the
(7) Record frequent blood pressure readings on the form's graphic portion by
entering an "X" between the columns and rows of dots, at points equivalent to systolic and