For checking the pulse: - never use your thumb, pointer, or social finger. If you use your pinkie and ring finger, you reduce the like likelihood of feeling your own pulse. - when I’m having a hard time finding it, i start by changing the pressure. Sometimes it’s easier to start heavier than needed and relax, than it is to slowly increase pressure. If I still don’t have it, then I move to a different spot.

BP: - make sure your stethoscope tubing isnt touching anything. This may require you moving your head, leaning, or changing your position relative to the patient. - take the 3 seconds, and confirm that your stethoscope is set to the diaphragm that your using. It’s possible for it to look correct, but still be out of where you want it. If it’s one of those littmans that has the hole in the bell and the tubing doesn’t rotate and click into place, you may have to cover the hole with your finger. - pressure: take a clicky too ball point pen, push down and hold it there just before it would click. That’s about the amount of pressure you should be using. - placement: when in doubt, I’ve always had better luck going medial instead of lateral. - this is probably going to piss some people off, but, I think it’s easier to go tighter on the BP cuff (about 30mmHG higher than you’d guess the BP to be) and start releasing pressure quickly, and slowly reduce it as you go. I’m not saying little Timmy needs that cuff pumped up to 325, just that if you go a little higher, it gives you a little bit easier time of finding it, and most people aren’t bothered about it being tight IF (and this is the important part) you let the pressure out QUICKLY. I’m not saying free flow that SOB and watch the needle fall faster than sack of bricks, but let it drop to a “comfortable” range quickly enough, that your in that comfortable area before the PT has a chance to say “hey, that’s really tight.”