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VOL: 99, ISSUE: 14, PAGE NO: 29

- The pulse is a series of pressure waves within an artery caused by contractions of the left ventricle (McFerran, 1998).

- It can be felt where an artery is near the surface of the body.

- In a healthy person the resting heart rate is 70-80 beats per minute.

- Tachycardia: rapid resting heart beat - over 100 beats per minute.

- Bradycardia: slow resting heart beat - under 60 beats per minute.

The site most commonly used to palpate the pulse is the wrist (radial pulse). Other pulses recorded are:

- Ulnar - at the wrist and in line with the small finger;

- Carotid - to the front of the neck;

- Brachial - in the join of the elbow (usually used for recording blood pressure);

- Femoral - felt in the groin;

- Popliteal - found behind the knee;

- Apical - a stethoscope is required to listen to the heart rate;

- Dorsalis pedis - found on the top part of the foot, between the big toe and the leg;

- Posterior tibial - found just to the lower side of the inner aspect of the ankle.

- To obtain information on the heart rate, pattern of beats and strength of the pulse.

- To determine the individual’s pulse on admission, as a baseline.

- To monitor changes in the pulse.

- It is not just the pulse rate that is recorded - its rhythm and strength are also measured.

- The rhythm should be regular in a healthy person.

- The pulse should be strong and easily palpated - if it is bounding or weak then this is an indication that there is a possible problem.

- Other vital observations that are recorded at the same time as the pulse are blood pressure, respirations and temperature.

- You will need a watch that has a second hand.

- Explain to the patient what you are about to do.

- Ensure that the patient is as relaxed as possible - one who is distressed may have a faster pulse.

- Note: if the patient has taken any medication - this may alter the pulse rate.

- For convenience and ease it is best to record the radial pulse.

- Place your first and second finger along the artery - apply light pressure until you feel the pulse.

- Count the pulse for a full minute in order to detect any arrhythmias (abnormal rhythms).

- Make sure that the patient is comfortable.

- Document your findings on the patient’s observation chart.

- If the pulse is irregular this should be documented in the patient’s notes.

- Report any changes or irregularities to the nurse in charge and to the medical team.

The frequency of recording a patient’s pulse depends on their condition and illness.

A pulse recording is also required when a patient:

- Is receiving a blood transfusion;

- Is postoperative;

- Has cardiac problems;

- Is critically ill;

- Has an infection.

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