Pulse

Why does the patient’s/client’s pulse need to be checked?

When the heart contracts and pumps blood round the body, the vessels the blood runs through (the arteries) expand as the wave of blood passes. We can feel this ‘pulse’ where the arteries pass over a solid structure like bone – the wrist is a good example.

The pulse – its rate (the number of times per minute we can feel the pulse), its strength (whether it’s full and ‘bounding’ or weak and ‘thready’) and its rhythm (regular or irregular) – can tell us a lot about the patient’s/client’s state of health.

When should I check it?

This will depend very much on why the patient/client is needing to access health services. The pulse can be taken along with the temperature and respiration rate as a baseline observation, or as part of a regular observation regime for someone whose health state is being monitored closely. It can be particularly important in the first day or so after a patient has had an operation, as a rapidly increasing pulse rate could indicate that the patient is bleeding internally and needs emergency help. The times to check the pulse will be set out in the patient’s/client’s care plan.

How do I check it?

Have a look at the slideshow on how to take a pulse.


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A pulse can be felt (palpated) in any artery lying close to the skin's surface. The carotid pulse is easy to access and feel.

Carotid pulse

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The carotid artery runs up and down along both sides of the neck. To find the carotid pulse, place your fingers at the top of the neck, just under the jaw at about the mid-point between the earlobe and the chin.

Carotid pulse

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To find the carotid pulse, place your fingers at the top of the neck, just under the jaw at about the mid-point between the earlobe and the chin.

Carotid pulse

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Place your first and second fingers along the artery and press gently. Count each pulsation for 60 seconds.

Carotid pulse

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Document the pulse rate in the person's record. Report any abnormal readings immediately to a registered nurse.

Carotid pulse


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Radial pulse

A pulse can be felt (palpated) in any artery lying close to the skin's surface. The radial artery is most commonly used as it is easy to access and feel.

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Radial pulse

The radial artery is on the 'thumb side' of the wrist when the palm is facing upwards half way between the tendons that run down the centre of the forearm and the edge of the 'thumb side' of the arm, down at the wrist.

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Radial pulse

Place your fingers half way between the tendons that run down the centre of the forearm and the edge of the 'thumb side' of the arm, down at the wrist.

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Radial pulse

Place your first and second fingers along the artery and press gently. Count each pulsation for 60 seconds.

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Radial pulse

Document the pulse rate in the person's record. Report any abnormal readings immediately to a registered nurse.


What do my findings mean?

We need to make sure that we take all factors into consideration when assessing the pulse. A rate that is a fair bit higher than the patient’s/client’s normal rate might alarm us, but we need to check a few things before jumping to wrong conclusions. For instance, has the person recently smoked a cigarette, or has he or she just taken part in some strenuous physical activity, or is he or she feeling nervous or angry about something? All of these factors can cause a pulse rate to rise. If you find there might be a simple cause of the pulse rate change, encourage the person to relax and come back in 15−30 minutes and check the rate again.

The rate isn’t the only thing that’s important. We need also to be aware of changes to:

  • the strength of the pulse – whether it’s stronger or weaker than usual
  • the rhythm – whether a previously regular pulse becomes irregular, or vice versa.

Changes to the pulse like this may, or may not, be important. What is important, however, is that you detect the changes, and that you record and report them to the registered person in charge.

Where should I record and report my findings?

The patient/client will have a chart on which your pulse observations can be recorded. You should make sure you record your findings clearly and accurately so that they can be readily seen and understood. Always follow your organisation’s policies and procedures on recording and reporting.

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