Radial (wrist) pulse taking

Authors: Simulation and Certification Center

Editor: Rednenko V.V.

Clinical situation:

During first aid, a person complains of palpitations. Check his heart rate.

Equipment for the practical skill:

• protective medical gloves;
• stopwatch;
• patient care simulator or simulated patient.

The procedure for performing a practical skill

• Introduce yourself.
• Obtain consent to help.
  • state the type and level of training that you have;
  • explain what you think is wrong;
  • explain what you plan to do;
  • ask for consent for the procedure.
• Treat your hands.
• Position the person appropriately:
  • In bed / on the floor: Position the person in Fowler's position (sitting up with the head of the bed elevated) or the supine position (lying on the back).
  • In a chair: Have the person sit with both feet flat on the floor. Position the arm so that it is resting comfortably on the arm of the chair or the person's lap.
• Ask patient to relax arms.
• Check the person's pulse is the same in both wrists or not:
  • grab the person's hands;
  • hold the person's right hand with your left hand and the person's left hand with your right;
  • place the thumb on the back of the hand and forearm, place the remaining fingers in one line on the forearm at the base of the thumb;

• • achieve the position and pressure of 3 fingers at which the pulsation of the artery is felt;
  • decide whether the pulsation is the same on both hands or not.
• Check the pulse rhythm (regular or irregular):
  • if the pulse is the same on both hands, continue to check the pulse on one arm;
  •   if the pulses of both arms are different, test the pulses on each arm separately;
  • сheck the pulse rhythm at least 30 second
  • decide whether the pulse is regular or irregular. 
• Check the pulse rate:
• o   if the rhythm is regular count the pulse for thirty seconds and multiply by two to report in beats per minute.
• o   if the rhythm is irregular count the pulse for one minute.

• Tell the patient the results.
• Register the result (if necessary).
• Treat your hands.