Pulse refers to the rhythmical throbbing of an artery caused by the regular contractions of the heart. It can be felt on different areas of the body using the index and middle fingers. It also can be heard through a stethoscope--a medical instrument used for detecting sounds produced by the body. For many healthy individuals, taking the pulse is the same as taking the heart rate. But for those suffering from cardiac arrhythmia (abnormal electrical activity of the heart), their heart rate may be higher than their pulse rate. Normal adult pulse rate ranges from 60 to 100 beats per minute. Here are some helpful tips on how to take the pulse on different pulse pressure sites of the body.
Things You'll Need
- Clock or watch with a second hand
Locate the temporal pulse of your patient. First you are to palpate a bony prominence called the zygomatic arch in order to locate the temporal pulse. Use your index and middle fingers to feel the zygomatic arch in front of your patient's ear, specifically near the small pointed eminence (tragus). Then move your fingers slightly above it to feel the pulsation of the temporal pulse. Count the beats of the temporal pulse for 60 seconds (1 minute), and then record it. Record the pulse in the same manner for the following steps.
Find the carotid pulse of your patient around the area of his neck. To find the carotid pulse, run your index and middle fingers alongside your patient's windpipe (trachea) located on the anterior or front part of the neck. You can feel the pulse on either sides of the patient's neck, but you must not press on both arteries at the same time. The carotid pulse is normally taken when cardiopulmonary resuscitation (CPR) is performed.
Instruct your patient to sit or lie down in order for you to take his apical pulse. The apical pulse is the heartbeat at the apex or the uppermost point of the heart--which is taken through the use of a stethoscope. Put on the earpieces of the stethoscope and begin your auscultation. With your patient sitting or lying supine, place the disk of the stethoscope below the left nipple of your patient, just between the fifth and sixth ribs. Listen for the patient's heartbeat.
Let your patient sit comfortably with either his left or right arm resting on the table. Turn his right or left arm so that his palm is facing upward. Using your index and middle fingers, palpate his brachial artery by positioning your fingers on the medial side (the side near his body) of his cubital fossa (the crease in between the forearm and the upper arm situated above the elbow). If you can't feel it during your first palpation, you can run your fingers from the center of the crease going toward his body. This way, you can easily feel the pulsation of his brachial artery. This pulse is usually palpated when taking the patient's blood pressure.
Ask your patient to turn his right or left arm so that his palm is facing up. Feel his radial pulse by placing your index and middle fingers on his wrist, below the area of his thumb. The radial pulse is the easiest pulse to locate and is the most common site for taking pulse measurements.
Palpate your patient's ulnar pulse by instructing him to turn his right or left arm so that his palm is facing up. Like the radial pulse, you are to locate the patient's ulnar pulse through his wrist. The only difference is, you are palpating the ulnar pulse on the other side of his wrist, which is below the area of his little finger.
Check the circulation of your patient's leg by taking his femoral pulse. With your patient lying on his back and legs extended, palpate for the femoral pulse around the area of his groin. Using your index and middle finger, press the right or left femoral artery against the ischium--the lower part of the hip bone.
Take your patient's popliteal pulse. Tell your patient to lie on his back, and flex his right or left knee at approximately 120 degrees. Hold his knee with both hands. Extend the index and middle fingers of your hands on his popliteal fossa (the crease located at the back of his knee), and palpate his popliteal artery.
Monitor the circulation of your patient's foot by palpating his dorsalis pedis pulse. You can feel this pulse by positioning your index and middle fingers in the middle of the anterior or front part of his foot.
Assess the blood flow of your patient's lower leg and foot through the posterior tibial pulse. To feel this pulse, position your index and middle fingers at the back of his right or left ankle, specifically behind the medial malleolus (the bony prominence located on the medial or inner side of the foot).