Assessing Radial Pulse

Methodology of taking radial pulse

1. SMOLENSK STATE MEDICAL UNIVERSITY ASSESSING RADIAL PULSE - Joisy Aloor & Mitchele Kaka Group No:113

2. DEFINITION OF RADIAL PULSE Pulse of the radial artery(felt in the wrist). It is typically taken by applying finger pressure to the inner wrist and counting the heartbeats. Most common form of checking a pulse. Measuring the pulse provides information on the regularity of heartbeat(heart rhythm) and indication of strength of heart contraction.

3. ASSESSING RADIAL PULSE Left ventricle contracts causing a wave of blood to surge radial arteries called radial pulse. Felt by palpating lightly against underlying bone or muscle.

4. Radial pulse is felt by light compression of the radial artery over the lower end of radius, in front of the wrist. The wrist should be relaxed to get a good pulse. Sometimes the radial artery may be aberrant and felt in the anatomical snuff box, on the lateral aspect of the wrist, just distal to the radius.

5. It is mandatory to check therefore concluding that the radial pulse is absent. Radial pulse is assessed further by a method known as trisection or Osler’s manoeuver (compression using three fingers). Compression by the first and last fingers occludes flow from radial artery and retrograde flow from ulnar artery through palmar arch. This helps us to assess the vessel wall thickness, which is done by the middle finger.

6. PROCEDURE Wash hands/hand hygiene. Reduces transmission of microorganisms. Inform the patient where pulse will be measured. Make sure the patient’s heartbeat is at its resting rate. Straighten the patient’s elbow and face the inside of his/her wrist upward.

7. Position the index and middle finger of your dominant hand so the tips of the two fingers align. Ask the patient to form a fist. With the help of your finger tips, apply pressure on patient’s wrist till you feel his/her pulse. Count the number of heartbeats in 30 seconds.

8. To obtain the patient’s pulse multiply the number with 2. Continue for 1 minute if the patient’s heartbeat is irregular. Record the medical result in the patient’s medical chart as per instructions. At last wash your hands again in order to prevent spreading of infection.

9. RATE & RHYTHM Normal: 60-100 bpm , average 80 bpm. Tachycardia: greater than 100 bpm. Bradycardia: less than 60 bpm. Rhythm: the pattern of the beats(regular/irregular) In addition to gender and age, exercise, medications, decrease in oxygen saturation, blood loss, body temperature can all influence a patient pulse rate.

10. AGE HEART RATE (BEATS/MIN) INFANTS 120-160 TODDLERS 90-140 PRESCHOOLERS 80-110 SCHOOL AGERS 75-100 ADOLSCENTS 60-90 ADULTS 60-100 NORMAL HEART RATE

11. OUTLOOK Assessing radial pulse rate assess the rhythm, strength, and rate of a patient’s peripheral pulse provides valuable information about the cardiovascular system. The rhythm of the pulse is usually regular, reflecting the time interval between each heartbeat. The strength of the pulse correlates with the volume of blood being ejected against the arterial walls with each contraction of the heart.

12. Pulse strength is usually described as absent, weak, diminished, strong, or bounding. If blood volume decreases, the pulse is often weak and difficult to palpate. If blood volume increases, the pulse is often bounding and easy to palpate. Although peripheral pulses are palpable at a variety of body sites, the radial pulse is the easiest to access and is therefore the most frequently checked peripheral pulse.

13. Assessment of other peripheral sites, such as the carotid or femoral pulses, is not usually part of routine vital-sign measurement. Clinicians typically access these sites when performing a complete physical examination. When they cannot palpate peripheral pulses, they use a Doppler ultrasound stethoscope to confirm the presence or absence of the pulse.

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