Pulse

General Objectives:-

At the end of this lecture the student should be able to demonstrate basic
knowledge related to Pulse.
Specific Objectives:-
At the end of this lecture the student should be able to:
Identify Pulse
Mention Purpose Assessing of Pulse
Discuss Characteristics of Pulse
Enumerate Sites for Checking Pulse
Discuss Alternations of Pulse
Describe Procedure of Taking Pulse
Enumerate Scientific Principle for taking Pulse
List Factors affecting Pulse

Outlines:-

 Definition of Pulse.
 Purpose of Assessing Pulse.
 Characteristics of Pulse.
 Sites for Checking Pulse.
 Alternations of Pulse.
 Procedure of Taking Pulse.
 Factors affecting Pulse.
 Scientific Principle for taking Pulse.

Definition of Pulse:

The pulse is the vibration of each wave of blood going through the
arteries as the heart beats.
Pulse Sites:
1. Radial:The most common site for measuring the pulse is the radial
artery, which is located in a groove on the inner aspect of the wrist
just below the thumb.
2. Apical:The apical pulse has a stronger beat and is easier to measure
than the other pulse sites.
3. Brachial:The brachial pulse is in the antecubital space, which isthe
space located at the front of the elbow.
4. Temporal:The temporal pulse is located in front of the ear and just
above eye level. This site is used to measure pulse when the radial
pulse is inaccessible.
5. Carotid:The carotid pulse is located on the anterior side of the
neck, slightly to one side of the midline, and is the best site to find
a pulse quickly.
6. Femoral:The femoral pulse is in the middle of the groin. This site
is used to measure pulse during cardiac arrest and to assess the
status of the circulation to the lower leg.
7. Popliteal: The popliteal pulse is at the back of the knee and is
detected most easily when the knee is slightly fixed. This site is
used to measure blood pressure when the brachial pulse is 39
inaccessible and to assess the status of the circulation to the lower
leg.
8. Posterior Tibia l: The posterior tibial pulse is located on the inner
aspect of the ankle just posterior to the ankle bone. This site is used
to assess the status of circulation to the foot.
9. Dorsalis Pedis: The Dorsalis pedis pulse is located on the upper
surface of the foot, between the first and second metatarsal bones.
This site is used to assess the status of circulation to the foot.

Factors Affect the Pulse Rate:

The pulse rate is an indicator of how fast the heart beats. The pulse rate
is affected by several factors.
1. Age: A normal pulse for infants range from 90 to 170 and the rate
gradually decreases up to age 14 when it is equal to the normal
adult pulse rate of 60 to 100.
2. Body Build and Size: A short, fat person may have a higher rate
than a tall, slender person.
3. Blood Pressure: As the blood pressure decreases, the pulse will
frequently increase.
4. Medications: Stimulants will increase the pulse rate; depressants
will decrease the pulse rate.
5. Exercise and Muscular Activity: An increase in pulse rate will
occur with increased activity to meet increased oxygen and nutrient
demands. A regular aerobic exercise program can lower the resting
pulse.
6. Food Intake: Digestion increases the pulse slightly.
7. Elevated Body Temperature: The pulse increases approximately
10 beats per minute for every 1 F (0.56º C) increase in body
temperature. These conditions cause a temporary increase in the
heartbeat and pulse.
8. Emotional Status: Fear, anger, and anxiety will all increase the
pulse rate.
9. Pain: When the patient is in pain, the pulse rate will increase.
The Purpose of Measuring Pulse:
1. To establish the patient‘s baseline pulse rate.
2. To assess the pulse rate after special procedures, medications, or
disease processes that affect heart functioning.
An accurate assessment of pulse includes a determination of the pulse
rate, the pulse rhythm, and the pulse volume:
Pulse Rate:
1. The pulse rate is the number of heart pulsations or heart-beats that
occur in 1 minute; therefore, pulse rate is measured in beats per
minute.
2. Normal pulse rates vary widely in the various age groups.
3. For a healthy adult, the normal resting pulse rate ranges from 60 to
100 beats per minute.
Tachycardia:
1. An abnormally fast heart rate of more than 100 beats per minute.
2. May indicate disease states, such as hemorrhage or heart disease
and during vigorous exercise or during strong emotional states.
Bradycardia:
1. It‘s an abnormally slow heart rate, less than 60 beats per minute.
Pulse Rhythm:
1. The pulse rhythm denotes the time interval between heart-beats; a
normal rhythm has the same time interval between beats.
2. Any irregularity in the heart‘s rhythm is known as a dysrhythmia
(also termed arrhythmia) and is characterized by unequal or
irregular intervals between the heartbeats.

Pulse Volume:

1. Pulse volume refers to the strength of the heartbeat. The amount of
blood pumped into the aorta by each contraction of the left
ventricle should remain constant, making the pulse feel strong and
full.
2. If the blood volume decreases, the pulse feels weak and may be
difficult to detect. This type of pulse is usually accompanied by a
fast heart rate and is described as athready pulse.
3. An increase in the blood volume results in a pulse that feels
extremely strong and full, known as a bounding pulse.

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