Surveillance | Procedures

Measuring Height

Complete the following steps to measure and document height:

1. Place the height measuring board on a hard, flat surface (preferably against a wall)
2. Ensure the privacy of measurements
3. Have the child remove any footwear or headgear that may alter the measurement (braids, barrettes, etc.)
4. Place a paper towel under the child’s feet if he/she is not wearing socks.  Confirm the child is standing erect with the feet together in the center of the base of the height measuring board
5. Instruct the child to look straight ahead so that his/her line of sight is parallel with the floor
6. Make sure the child’s shoulders are level and his/her hands are at the sides
7. Place your open left hand on the child’s chin
8. With your right hand, lower the sliding headpiece on top of the child’s head
9. Read the measurement to the nearest quarter inch
10. Record on appropriate forms

Measuring Weight

Complete the following steps to measure and document weight:

1. Make sure the scales are operating correctly and set to weigh in pounds. View (opens in a new tab)this sample. 
2. Avoid carpeted floors.  Children may not weigh enough to take the “bounce” out of the carpet padding and this can lead to under-weighted readings or other irregularities in obtaining their weight.  View (opens in a new tab)this sample.
3. Provide for privacy since weight can be a sensitive matter.
4. If the child is not wearing socks, have a clean paper towel ready to place on the scale.  Discard after use.
5. The window will probably be blank since the scales shut off after a few minutes.
6. Tap the scales lightly with your foot.  SECA should appear in the window, followed by 8, and then by 0.  The scales will not display the weight unless the 0’s are registered when the student steps on it. View (opens in a new tab)this sample.
7. When the 0 appears, ask the child to step squarely on the scales and stand still.
8. When the numbers stabilize, record the weight in pounds and tenths of pounds as displayed.
9. Record on appropriate forms.

Screening for Acanthosis Nigricans (AN)

Complete the following steps to check for the presence of AN:

1. Carefully look at the back and the sides of the neck for signs of skin discoloration that is similar to a rash.  It can be helpful to feel the area to determine thickness.  Even a small amount of skin thickness and darkness is diagnostic for this disorder.
2. Early AN shows up as a small line of darker skin less than one centimeter (less than ½ inch) wide.  It can grow to over 3 centimeters (more than 1 inch) wide and can circle the entire neck.
3. Use a Data Collection form to mark the student as Yes or No for AN.

Download our flyer about AN

Checking Blood Pressure

WV CARDIAC Project blood pressure screenings are completed using the Welch Allyn Blood Pressure Monitor - 1700 series with Sure BP Technology.  Instructions here: link PDF document of instructions (provided as a separate attachment)

Complete the following steps to measure and document blood pressure:

1. Set up equipment: Insert or replace the batteries if the battery charge indicator indicates a low charge, the display dims, or the display does not light up.
2. Connect the blood pressure air tube to the plug on the left side of the blood pressure monitor by placing your thumb and forefinger on the metal air tube connector and sliding it onto the air connector plug.  Confirm that the air tube connector locks into place by listening for a click. 
3. Ensure use of the right size cuff.
   1. You are provided with both pediatric and adult sized cuffs.  Choose the cuff based on the student’s upper arm measurement.  The pediatric cuff is 15 cm-14cm and the adult cuff is 22 cm-42 cm.
   2. Use of an improperly sized cuff can yield inaccurate readings.
4. Position the blood pressure cuff.
   1. Remove any sleeves covering the upper arm.
   2. Place the cuff loosely over the arm so that the blood pressure tube extends down over the hand. 
   3. Open the cuff to resize it as needed and slide it over the bare upper arm.  The bottom edge of the cuff should be 2-3 centimeters above the bend in the arm, and the tube and artery marker should run down the palm-side of the lower arm. 
   4. Keeping the artery marker and the tube in place, wrap the cuff snugly around the arm, but not too tight.  Just tight enough that you can still insert two fingers between the cuff and the arm. 
5. Start the measurement.
   1. The student should sit comfortably in a chair with back support with their legs uncrossed and feet flat on the floor.  The arm should be supported on a flat surface.  The cuff should be level with the heart.
   2. Press the Power button to power up the monitor and begin the measurement.  The cuff inflates and tightens around the arm until it completes the measurement.  A vertical stack of segments appears onscreen to show increasing pressure in the cuff.  The heart icon in the upper-left corner blinks to indicate the pulse rate until the measurement is complete.  When the inflation cycle is complete, systolic and diastolic measurements as well as the pulse rate appear onscreen.
6. Disconnecting the blood pressure air tube.
   1. Note:  You may leave the air tube connected to the monitor if you can store the monitor and cuff in a convenient place and not kink the tube.
   2. If you choose to disconnect the air tube, place your thumb and forefinger on the grooved portion of the metal air tube connector and pull it back.  Do not twist the connector.  Gently pull the air tube away from the monitor. 
7. Record on appropriate forms.