Miscellaneous / How To Take A Patient'S Pulse
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Autor: anton 05 January 2011
Words: 767 | Pages: 4
How to Take a PatientÐ²Ð‚â„¢s Pulse.
Your pulse is a great source of information, often warning you when your body needs to take things easy or if there is a medical condition. A pulse is the audible product of the expansion and contraction of the arteries when the heart pumps the blood through our bodies (Ð²Ð‚ÑšTaking Vital SignsÐ²Ð‚Ñœ 3-1). Proper measurement of the heart rate is a critical element in the medical field for assessing patient conditions. In emergency situations, the pulse rate can help determine if the patient's heart is pumping properly. The typical heart beat for a healthy adult will range from approximately 60-100 beats per minute and will reach higher ranges for children (70-120 beats), toddlers (90-150 beats) and newborns (120-160 beats) (Ð²Ð‚ÑšTaking Vital SignsÐ²Ð‚Ñœ 3-3). The pulse can be taken at several locations on the body and may vary depending on the patientÐ²Ð‚â„¢s condition. The following process will be used to obtain a patientÐ²Ð‚â„¢s pulse through the wrist or elbow.
Items needed for assessment:
1). A clock or watch displaying a second hand.
2). A patient with accessibility to their arm.
3.) Patience and a gentle touch.
Course of Action:
Step 1. Approach the patient in a sitting or standing position, whichever is most comfortable for you and the patient (Rathe, Ð²Ð‚ÑšVital SignsÐ²Ð‚Ñœ 5).
Step 2. Take hold of the patientÐ²Ð‚â„¢s arm in a gentle manner and turn their hand so that the palm is up (Rathe, Ð²Ð‚ÑšVital SignsÐ²Ð‚Ñœ 5).
Step 3. Place your first and second index fingertips firmly on the thumb side of the wrist or elbow as shown in figure 1.0 below (Ð²Ð‚ÑšTaking Vital SignsÐ²Ð‚Ñœ 3-4). If you are unable to locate the pulse, put your fingers in multiple areas around the wrist or simply try the other arm.
Figure 1.0 Taking a pulse (Ð²Ð‚ÑšVital SignsÐ²Ð‚Ñœ 8).
Step 4. Once a steady pulse is found, begin counting the heart beat when the clockÐ²Ð‚â„¢s second hand reaches the 12 (Ð²Ð‚ÑšVital SignsÐ²Ð‚Ñœ 9).
Step 5. Count the patientÐ²Ð‚â„¢s pulse for 60 seconds (or until the second hand reaches the 12 again). For a quicker approach, you may count the pulse for 15 seconds then multiply your result by four to calculate the beats per minute (Ð²Ð‚ÑšVital SignsÐ²Ð‚Ñœ 9). Keep in mind that your focus is not on watching the clock continuously, but on the actual speed, strength and rhythm of the pulse.
Step 6. Document and assess your results for any irregular activity. A regular pulse should consist of an evenly spaced heartbeat which may vary slightly with each breath (Rathe, Ð²Ð‚ÑšVital SignsÐ²Ð‚Ñœ 5). Pulse rates that are not in the regular range as indicated previously are classified as tachycardia or bradycardia. Tachycardia is apparent when the pulse rate is over 100 beats per minute. This can be due to a serious condition in the patient, or simply excessive exercise or movement. Bradycardia is when the patientÐ²Ð‚â„¢s pulse rate reaches below 50 beats per minute (Ð²Ð‚ÑšTaking Vital SignsÐ²Ð‚Ñœ 3-3). In any case of irregular activity, you should notify a physician.
The strength of the pulse is determined by the force of the blood flowing through the heart. A very strong heartbeat would be classified of Ð²Ð‚ÑšboundingÐ²Ð‚Ñœ strength. If the pulse is hard to detect, it would be classified with a Ð²Ð‚ÑšweakÐ²Ð‚Ñœ strength. A Ð²Ð‚ÑšstrongÐ²Ð‚Ñœ pulse is one that is less apparent than that of a Ð²Ð‚ÑšboundingÐ²Ð‚Ñœ strength, but more forceful than that of a regular (Ð²Ð‚ÑšTaking Vital Signs 3-3). Irregular strength of the pulse can lead to blood pressure difficulties and should be reviewed for possible medication treatments (Ð²Ð‚ÑšCardiovascular diseaseÐ²Ð‚Ñœ 17).
The rhythm of the beat refers to its uniformity. An irregular heart beat is when the rhythm does not have an even pattern but fluctuates. An intermittent heartbeat is a specific type of irregular pulse when a beat is skipped completely (Ð²Ð‚ÑšTaking Vital SignsÐ²Ð‚Ñœ 3-3). Diagram 2.0 on the following page illustrates the various heart rates, strengths, and rhythms.
Figure 2.0 Heart rates, strengths, and rhythms (Ð²Ð‚ÑšTaking Vital SignsÐ²Ð‚Ñœ 3-3).
Any abnormal heart rates, strengths, or rhythms should be reviewed immediately by a physician for further assessment since these could be signs of serious conditions such as a heart disease, arrhythmias, or critical blood loss. (Ð²Ð‚ÑšCardiovascular diseaseÐ²Ð‚Ñœ 2)
"Cardiovascular disease 101: Understanding heart and blood vessel conditions". Mayo
Foundation for Medical Education and Research (MFMER). 04/12/2008 <http://www.mayoclinic.com/health/cardiovascular-disease/HB00032>.
Rathe, Richard. "Vital Signs." 1996. 29 Mar. 2008
"Taking Vital Signs." Sweethaven Publishing Services. 2006. 29 Mar. 2008
"Vital Signs (Body Temperature, Pulse Rate, Respiration Rate, Blood Pressure)." University of
Virginia Health System. 29 Mar. 2008 <http://www.healthsystem.virginia.edu/uvahealth/adult_nontrauma/vital.cfm>.
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