Radial (wrist) pulse taking

Authors: Rednenko VV, Poplavets E.V.

Editor: Rednenko V.V.

Equipment for the practical skill:

• Stopwatch or watch with a second hand
• Pen and paper

Clinical situation:      

• You need to take a radial (wrist) pulse

Order of the skill performance:

Preparatory stage:

• Introduce yourself
• Identify patient
  • Use at least two identifiers (e.g., name and date of birth)
  • Use active communication whenever possible and ask the patient to state his or her full name and date of birth. (e.g., "Can you tell me your name and date of birth?" not "Mr. Smith I want to take your puls.")
•  Obtain informed consent to the procedure
  • Give all the information to the person about what the procedure involves, including the benefits and risks, whether there are reasonable alternative, and what will happen without this procedure
  • Explain what you are going to do.
  • Ask the patient to consent to 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 arm.
• Check your pulse is the same in both wrists or not
  • Grab the patient's hands
  • The patient's right hand is held by your left hand, the left hand is held by the right one
  • The thumb is on the back of the hand and forearm, the remaining fingers are on the artery (on the forearm at the base of the thumb)

• • If the pulse is the same on both hands, continue to check the pulse on one arm.
• Check the pulse rhythm (regular or irregular)
  • Hold one hand in the same position
  • Check the pulse rhythm at least 30 second
  • Make desision
    • pulse rhythm is regular
    • pulse rhythm is irregular
• Check the puls rate
  • Hold one hand in the same position
  • Count for thirty seconds if the rhythm is regular and multiply by two to report in beats per minute.
  • Count for one minute if the rhythm is irregular.

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