WHAT IS THE PULSE?
VOL: 99, ISSUE: 14, PAGE NO: 29
WHAT IS THE PULSE?
- 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.
RECORDING THE PULSE
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.
WHY IS THE PULSE RECORDED?
- 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.
WHEN AND HOW OFTEN?
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.