Correct pulse measurement

Pulse measurement is a key part of the assessment of a person's cardiovascular status and one of the primary vital signs assessed and recorded for every patient. Valuable information can be gained from the manual measurement of the pulse, which can be palpated at numerous sites across the body. It is therefore important to re-visit this key feature of patient assessment to ensure best practice is maintained.

This article will focus on explaining what a pulse is, the common pulse sites and correct technique in obtaining a pulse. Some, but not all, common interpretations and abnormalities will be discussed; however, these will not be explored in depth.

When the heart contracts and blood is ejected from the left ventricle, a pressure wave is generated and transmitted into the aorta and arterial tree. The flexible and elastic nature of artery walls enables this pulse wave transmission (Rawlings-Anderson and Hunter, 2008: Marieb and Hoehn, 2013). At certain points in the body, where arteries are either superficial or pass over a bone, these pulsations can be felt (Dougherty and Lister, 2015). In a healthy individual, the pulse rate represents the heart rate; however, there are circumstances whereby differences can occur such as with peripheral vascular disease or an acute arterial occlusion (Grossman and Porth, 2014; Waugh and Grant, 2018). If a peripheral artery is narrowed, damaged, occluded or diseased, the distal pulse may not represent the heart rate as a result of impaired blood supply. It is therefore important to check bilateral pulses to check for consistency (Gregory and Mursell, 2010). Manual assessment of the pulse is considered best practice as the clinician can assess for the rate, rhythm, volume and character.