How To Take A Patient's Pulse

How to Take a Patient’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 (“Taking Vital Signs” 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) (“Taking Vital Signs” 3-3). The pulse can be taken at several locations on the body and may vary depending on the patient’s condition. The following process will be used to obtain a patient’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, “Vital Signs” 5).

Step 2. Take hold of the patient’s arm in a gentle manner and turn their hand so that the palm is up (Rathe, “Vital Signs” 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 (“Taking Vital Signs” 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 (“Vital Signs” 8).

Step 4. Once a steady pulse is found, begin counting the heart beat when the clock’s second hand reaches the 12 (“Vital Signs” 9).

Step 5. Count the patient’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 (“Vital Signs” 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, “Vital Signs” 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 patient’s pulse rate reaches below 50 beats per minute (“Taking Vital Signs” 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 “bounding”