Common Pulse Points in Nursing Assessments

Importance of Pulse Points

• Essential for nurses to know common pulse sites for routine assessments.
• Assess pulse rate (speed), strength, and rhythm.
  • Strength Grading Scale:
    • 0: Absent
    • 1+: Weak
    • 2+: Normal
    • 3+: Bounding
• 4+
  • Rhythm: Regular or Irregular
• Some sites are checked bilaterally for equality, except the carotid.

Nine Pulse Points

1. Temporal Artery

• Location: Near the tragus of the ear, above the zygomatic arch (cheekbone).
• Assessment: Bilateral palpation to check for equality.
• Usage: Part of head-to-toe assessment.

2. Carotid Artery

• Location: Neck, below the jaw, between the trachea and sternomastoid muscle.
• Assessment: Evaluate each side separately.
  • Avoid simultaneous palpation to prevent stimulating the vagus nerve.
• Usage: Common during CPR in adults.

3. Apical Pulse

• Location: Left side of chest at the fifth intercostal space, midclavicular line.
• Assessment: Use a stethoscope to listen for one full minute.
• Usage: During head-to-toe assessment or before administering Digoxin.

4. Brachial Artery

• Location: Upper arm, near the cubital fossa (triangle area in front of the elbow).
• Assessment: Arm extended, palm up.
• Usage: Blood pressure assessment, CPR in infants.

5. Radial Artery

• Location: Wrist area below the thumb, along the radial bone.
• Assessment: Arm extended, palm up.
• Usage: Most common for measuring pulse rate in adults.

6. Femoral Artery

• Location: Groin, below inguinal ligament, between pubic symphysis and anterior superior iliac spine.
• Assessment: Requires deep palpation.

7. Popliteal Artery

• Location: Behind the knee, middle of the popliteal fossa (diamond-shaped area).
• Assessment: Flex knee for easier access.

8. Posterior Tibial Artery

• Location: Inside of the ankle, between the medial malleolus and Achilles tendon.
• Assessment: Palpate the specified area.

9. Dorsalis Pedis Artery

• Location: Top of the foot, near the extensor hallucis longus tendon.
• Assessment: Follow the tendon to locate the pulse.

General Tips

• Count pulse for 30 seconds and multiply by 2 if the rhythm is regular.
• For irregular rhythms or apical pulse, count for one full minute.

Conclusion

• Understanding and accurately assessing the common pulse points is crucial in nursing for effective patient assessment and care.