Personal Care and Support Pulse: Radial SECTION: 18.29

Personal Care and Support – Pulse: Radial SECTION: 18.29

Strength of Evidence Level: 1 __RN__LPN/LVN__HHA

PURPOSE:

To count how fast the heart is beating.

CONSIDERATIONS:

1. Characteristics of a pulse are:

a. Rate: Number of beats per minute.

b. Rhythm: Regularity of the pulse beats.

c. Force: Weak, pounding.

2. Normal pulse ranges are as follows:

a. 1 year old, 115 to 130 beats per minute.

b. Childhood years, 80 to 115 beats per minute.

c. Adult years, 64 to 80 beats per minute.

d. Senior years, 60 to 70 beats per minute.

EQUIPMENT:

Watch or clock with a second hand

PROCEDURE:

1. Adhere to Standard Precautions.

2. Explain procedure to patient.

3. Have patient sit or lie in a comfortable position. Wait 5 minutes before counting the pulse.

4. The patient's hand and arm should be well supported and resting comfortably.

5. Feel the pulse by placing the pads of your middle three fingers on the palm side of the patient's wrist in a line with patient's thumb. Press lightly until the pulse is felt. The thumb is never used because it has its own pulse. If you press too hard, you may stop the flow of blood and then you will not be able to feel a pulse.

6. When the pulse is felt, note the rhythm, whether it is steady or irregular; note the force of the beat, whether it is strong, weak or pounding.

7. Look at the position of the second hand on the watch or clock. Start counting the pulse beats (what is felt) until the second hand returns to the same number on the watch or clock.

a Method A: Count the pulse beats for one full minute and report the full minute count. This is always done if the patient has an irregular beat.

b Method B: Count for 30 seconds (until the second hand is opposite its position when you started). Multiply the number of beats by 2; record this number.

(1). EXAMPLE: If the count for 30 seconds is 35, the count for 60 seconds is 35 x 2 or 70 beats for 60 seconds.

AFTER CARE:

1. Document in patient's record:

a. Rate.

b. Rhythm.

c. Force of pulse.

2. Report any deviation from normal pulse to supervisor.

REFERENCES:

Leahy, W., Fuzy, J., & Graf, J. (1999). Providing home care: A textbook for home care aides. (3rd ed.) Albuquerque, NM: Hartman Publishing, Inc.

U.S. Department of Health and Human Services. (2004). Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. (NIH Publication No. 04-5230). Bethesda, MD.