Cleveland Family Study

9.2.4 Application of Blood Pressure Cuffs

1. Place 4 blood pressure cuffs on the participant and attach the sphygmomanometer to the arm cuff for the first reading.
2. Place one cuff on each arm.
   • Use the same arm and cuff size that were used for the seated blood pressure measurement.
   • If only one arm can be used please note the reason for the change.
3. Place one standard adult size (or appropriate size) cuff on each ankle
4. Apply the ankle cuffs with the midpoint of the bladder over the posterior tibial artery, with the lower end of the bladder approximately 3 cm above the medial malleolus.
   • Rarely, the velcro will not hold due to the ankles being very thin or large. In these cases use pediatric or large adult cuffs.
   • The size guidelines used above in the section on seated blood pressure can be applied here as well.
   • If not enough cuffs of the correct size are available; the appropriate cuff will need to be moved to make measurements.
5. Apply ultrasound gel on each limb over the appropriate artery at this time.