12.12: Special considerations while measuring pulse
Assessing a patient's pulse is a fundamental skill in healthcare, but certain situations require special attention:
- Irregular Pulse:
- • Count for a full minute to accurately assess the rate and rhythm when the pulse is irregular.
- • Document any irregularities, such as skipped beats or varying pulse strength.
- Disappearing Pulse:
- • If the pulse is palpable but intermittently disappears, avoid applying excessive pressure, which can suppress the pulse.
- • Gently palpate the area and mark the pulse location with a non-permanent marker if needed for repeated assessments.
- Absent Pulse:
- • An absent pulse might indicate a critical problem that warrants immediate action.
- • Use an ultrasound Doppler device to confirm the presence or absence of a pulse. Doppler devices are more sensitive and can detect pulses that are not palpable manually.
- • Notify the physician immediately if a pulse is absent or if there are significant irregularities.
- Age-Related Pulse Variations:
- • The average pulse rates vary with age. For instance, infants and young children typically have higher pulse rates than adults.
- Apical Pulse in Children Younger Than Two:
- • For children under two years of age, assess the apical pulse. In young children, peripheral arteries are more superficial and can easily compress, making peripheral pulses less reliable.
- Apical Pulse in Cardiac Patients:
- • Patients with congenital or acquired cardiac issues should undergo apical pulse assessment. This method provides a more precise evaluation of cardiac function for these patients.
- Assessing Apical Pulse for Irregular Peripheral Pulses:
- • An apical pulse assessment is also indicated in irregular, feeble, or highly rapid peripheral pulses. It helps to determine the heart rate and rhythm accurately.
