Pulse – is when the left ventricle of the heart contracts. When this happens the blood is suddenly pushed from the ventricle to the main artery(Aorta). This sudden forcing of blood from the heart into the arteries causes two things to happen.
1. Artery Expansion – The sudden rush of blood increases the volume of blood in the arteries inorder to accept this increased volume, the arteries expand(stretch). As the arteries quickly contract(go back to normal size), blood is forced from the arteries, through the capillaries and into the veins.
2. Pulse – In addition to the expansion of the arteries, a “wave” travels through the arteries. This wave is surface of the body.
** Artery is palpated whhen a pulse is taken:
1. Radial Pulse – is taken at a point where the radial artery crosses the bones of the wrist. If the patient’s hand is turned so that the palm is up, the radial pulse is taken on the thum side of top side of the wrist.
2. Carotid Pulse – is taken on either sude of the trachea(windpipe). The best location is grooves located to the right and to left of the larynx (Adam’s Apple).
3. Brachial Pulse – is taken in the depression located about one-half inch above the crease on the inside(not the body side) of the elbow. This site is used when taking the patient’s blood pressure.
4. Temporal Pulse – is taken in the temple area on either side of the head. The temple area is located in front of the upper part of the ear. The pulse is felt just above a large, raised bony are called the sygomatic arch.
5. Ulnar – just like radial pulse, ulnar pulse is taken at the wrist only ulnar is taken on the other side of the wrist.
6. Femoral – is taken in the groin area by pressing the right or left femoral artery against the ischium(the lower part of the pelvic bones located in the front part of the body)
7. Popliteal – is taken in the middle of the area located on the inside of the knee (the area opposite the kneecap)
8. Posterior Tibial – is taken at the top of the ankle or just above the ankle on the back, inside part of the ankle.
9. Dorsalis Pedis – is taken on the top portion of the foot just below the ankle.(Middle area and not in the inside or outside area of the foot)
10.Apical – unlike other sites, the apical pulse is not taken over an artery. Instead, it is taken over the heart itself. (heartbeat) that can be felt over the apex of the heart(pointed lower end of the heart). It is located to the patient’s left of the breastbone and two to three inches above the bottom of the breastbone. Apical pulse is easily heard when using stethoscope.
What is PULSE Rate?
It is a number of times that you can feel a pulse wave passing a point in one minute. Since a pulse wave occurs whenever t he heart beats, the pulse rate is equal the heartbeat rate. However, taking a patient’s pulse means more than just determining his pulse rate. It is also includes noting certain factor of a pulse.
What factors are noted when taking a patient’s pulse?
You should note the strength and regularity of the pulse.
Pulse Rate:
A. Normal adult has a pulse of about 72 beats each time. Infants have higher average pulse rate.
Normal Value
1. Adult 60 to 100 bpm
2. Children 70 to 120 bpm
3. Toddlers 90 to 150 bpm
4. Newborns 120 to 160 bpm
B. Pulse rates that are outside the normal range are classified as TACHYCARDIA or BRADYCARDIA
1. Tachycardia – patient pulse rate is over 100 bpm, meaning “swift heart”. Constant tachycardia could be a sign of a certain diseases and heart problems. Often, it is temporary. Temporary Tachycardia, can be caused by exercise, pain, strong emotion, excessive heat, fever, bleeding or shock.
2. Bradycardia – patient pulse rate is below 50 bpm, meaning “slow heart”. it can be a sign of certain diseases and heart problems.
Strength
The force of the pulse is determined by the amount of blood forced into the artery by the heartbeat. A normal pulse has normal strength. And you can identify a normal strength with practice.
1. Bounding – if heart is pumping a large amount of blood with each heartbeat, the pulse will feel very strong (by leaps and bounds) which can be caused by exercise, anxiety, or alcohol comsumption.
2. Weak – if heart is pumping small amount of blood with each heartbeat, the pulse will be harder to detect. It is weak, feeble, or thready. If this happen you may have trouble finding(palpating) the first pulse.
3. Strong – is stronger than normal but is less than bounding. Shock and hemorrhage(serious bleeding) can cause strong pulse.
Rhythm
Is refers to the evenness of of the beats. In a regular pulse, the time between beats is the same(constant) and the beats are of the same strength.
1. Irregular -when the rhythm does not have an even pattern. The time between beats may change, or the strength of the beats may change or the pulse may vary in both time between beats and strength.
2. Intermittent – is a special type of irregular pulse. A pulse is intermittent when the strength does not vary greatly, but a beat is skipped(missed) either at regular or irregular intervals. if the missing beats in an intermittent pulse were present, then the pulse rhythm would be normal.
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