Mastering Pulse Checks: Learn How to Check Pulse for Everyone

Checking your pulse helps you understand your heart rate, a key indicator of cardiovascular health.  Pulse check helps identify if your heart rate is normal, too fast, too slow, or irregular, which signals potential heart issues. It’s useful for routine health monitoring and critical in emergencies, such as during CPR, to guide immediate medical action.This guide will cover what is pulse, how to find the right pulse location, how to check your pulse rate, and what to do if there is no pulse detected.

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What is Your Pulse?

Your pulse is a measure of your heartbeats per minute. It's the sensation you feel when blood moves through your arteries each time your heart beats. When your heart beats, it contracts to pump blood through your arteries, causing a brief rise in pressure. This pulse is what you feel as the heart pushes blood through the body. After each beat, the heart relaxes, lowering the pressure until the next beat.

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What are the 7 Pulse Points?

The human body has several accessible pulse points where arteries are close enough to the skin for the heartbeat to be felt. Here are seven primary pulse points:

• Carotid Artery: Located on the neck, beside the windpipe. This pulse point is commonly used in emergencies for quick access.
• Radial Artery: Found on the wrist, near the base of the thumb. It’s commonly used in routine health checks.
• Brachial Artery: Located on the inside of the upper arm, near the elbow. This is the preferred pulse point for infants.
• Femoral Artery: Found in the groin area, along the inner thigh. This pulse point is sometimes used in emergencies when other points are not accessible.
• Popliteal Artery: Located behind the knee. It’s harder to locate and is less commonly used.
• Dorsalis Pedis Artery: Found on the top of the foot, near the ankle. This pulse point is often used to check blood flow to the lower limbs.
• Posterior Tibial Artery: Located on the inside of the ankle, behind the bony prominence. This is another pulse point used to assess circulation in the legs.

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What is the Most Accurate Pulse Site?

The carotid artery is considered the most accurate pulse site, especially in emergency situations and when checking for a strong, central pulse. The carotid artery is large and located close to the heart, making it easier to detect a clear and strong pulse. For routine checks on healthy individuals, the radial artery (wrist) is also highly reliable and accessible. However, for infants, the brachial artery is preferred due to its ease of access and reliable pulse in younger children.

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How to Find the Right Pulse Location?

Locate the appropriate pulse point based on their age.

• For adults and children (over 1 year), feel for the pulse on the neck (carotid artery).
• For infants (under 1 year), check the upper arm (brachial artery) between the shoulder and elbow.

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Use your index and middle fingers, as the thumb has its own pulse, which could lead to confusion. The aim here is to detect a strong, steady beat that confirms the heart is pumping blood. This step typically takes around 5 seconds to locate the correct artery. If you have trouble finding the pulse, avoid pressing too hard and gently reposition your fingers.

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How to Check Pulse?

Before checking your pulse, sit or lie down for five minutes to avoid activity-related changes. Avoid smoking or drinking caffeine beforehand. The easiest places to feel your pulse are wrist (Radial Artery) and neck (Carotid Pulse).

To Check Your Pulse on Your Wrist:

1. Turn your palm upward.
2. Place the middle three fingers of your other hand in the groove on your wrist, just below the thumb.
3. Press firmly until you feel a pulsing sensation. If not, apply a bit more pressure.
4. Count the beats for 30 seconds using a clock or stopwatch.
5. Double this count to get your heart rate in beats per minute (bpm). For example, 40 pulses counted in 30 seconds would mean a heart rate of 80 bpm.

To Check Your Pulse on Your Neck:

1. Place your index and middle fingers on the side of your neck, in the groove below your jawline and next to your windpipe.
2. Press gently until you feel the pulse. If needed, adjust your fingers slightly and increase pressure.
3. Count the pulses for 30 seconds, then double it for your bpm.

Alternatively, count the beats for 10 seconds and multiply by 6 for your bpm.

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What to Do if No Pulse is Felt?

If you cannot detect a pulse after several attempts, especially in an emergency situation, proceed to CPR if necessary, and seek medical help immediately.

• If No Pulse: Begin CPR with chest compressions at a rate of 100–120 compressions per minute.
• If Pulse Is Present but No Breathing: Start rescue breathing, giving one breath every 5–6 seconds.

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Making this decision promptly helps ensure you’re delivering the right type of assistance based on the person’s needs, potentially preserving their life until emergency responders arrive. You may find a timer helpful for timing breaths and compressions accurately, but if one isn’t available, you can count to yourself at a steady pace. In cases where the pulse or breathing signs are unclear, it’s generally safer to begin chest compressions than to wait, as immediate action can be critical in life-threatening situations.

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How does pulse checking differ between children and adults?

Pulse checking differs between children and adults in terms of technique and considerations. For children, the radial or brachial arteries are commonly used, and a lighter touch is needed due to their smaller size and more delicate pulses.

In adults, the radial artery is a standard location, and the pulse is typically counted for 15 seconds, with the result multiplied by four for the beats per minute. The pressure applied is slightly firmer, given the larger size of adult arteries. Additionally, adults may have more consistent pulse patterns than children's naturally variable patterns. 

How do you assess the brachial pulse of an infant?

To check the brachial pulse in an infant, place two fingers (usually your index and middle fingers) on the inner side of the infant’s upper arm, between the shoulder and elbow. Press gently, just firm enough to feel for a beat without obstructing blood flow. This area is preferred in infants because it is more accessible and offers a reliable pulse in small children

What is an apical pulse and how do you check it?

An apical pulse refers to the measurement of the heart rate by listening directly to the heartbeat at the apex (bottom) of the heart. This is typically done using a stethoscope placed at the point where the mid-clavicular line intersects with the fifth intercostal space on the left side of the chest. The apical pulse is often used in specific medical situations, especially in pediatric care, where it provides a more accurate assessment of heart function, particularly in infants and young children. This method allows healthcare professionals to listen to the heart sounds and detect any irregularities or abnormalities in the rhythm and rate of the heartbeat.

Can you check a pulse in the foot, and if so, how?

Yes, it is possible to check a pulse in the foot. The dorsalis pedis pulse, located on the top of the foot, is commonly assessed. Here's how to check the pulse in the foot:

1. Locate the Pulse Point: The dorsalis pedis pulse is usually found on the top of the foot, just lateral to the extensor tendon of the big toe. It's typically checked on the side of the foot facing upward.
2. Use the Correct Fingers: Use the index and middle fingers to feel for the pulse. Gently press your fingers over the area, applying enough pressure to feel the pulsation.
3. Apply Consistent Pressure: Maintain a consistent and light pressure while feeling for the pulse. Pressing too hard can obstruct the artery and affect the accuracy of the reading.
4. Count the Beats: Count the number of beats for a specific duration. The standard practice is to count for 15 seconds and then multiply by four to determine the beats per minute (BPM).

Checking the pulse in the foot can be particularly useful in situations where the radial pulse (wrist) or the carotid pulse (neck) is not easily accessible or in specific medical scenarios. However, keep in mind that assessing the foot pulse is not as common in routine health monitoring as checking pulses in more traditional locations. If you have difficulty finding or assessing the pulse in the foot, it's advisable to seek guidance from a healthcare professional.

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How long should you check for a pulse before taking further steps?

Check for a pulse for no more than 10 seconds. If you don’t detect a pulse within this time, assume there is no pulse and begin CPR immediately. Prolonging the pulse check can delay critical interventions.

What's a normal resting heart rate?

According to Edward R. Laskowski, M.D., a normal resting heart rate for adults ranges from 60 to 100 beats per minute. A lower resting heart rate generally indicates more efficient heart function and better cardiovascular fitness. For instance, well-trained athletes might have resting heart rates closer to 40 beats per minute due to their enhanced heart efficiency. Several factors can affect heart rate, including:

• Age
• Fitness level
• Smoking
• Health conditions (cardiovascular disease, high cholesterol, diabetes)
• Environmental factors (air temperature)
• Body position (standing or lying down)
• Emotions
• Body size
• Medications

Though there is a broad range of what is considered normal, persistent heart rates above 100 bpm (tachycardia) or below 60 bpm (bradycardia) may indicate underlying issues. It’s advised to consult a doctor if you experience these rates, especially if accompanied by symptoms like fainting, dizziness, or shortness of breath, unless you are an athlete with naturally lower heart rates.

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What if My Heart Rate is Too Low?

A heart rate below 60 bpm (bradycardia) can be normal if:

• You’re an athlete
• You’re asleep
• You’re taking medications that slow your heart rate

However, seek medical advice if a low heart rate is accompanied by fainting, fatigue, or dizziness.

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What if My Heart Rate is Too High?

A heart rate over 100 bpm during activity is typical, as your body needs more oxygen. You might also notice a higher rate if you’re dehydrated or unwell. But if your resting heart rate is over 100 bpm and you feel dizzy or experience palpitations, contact your doctor.

What are the Common Challenges in Checking Pulse?

Pulse checking, although apparently simple, presents several challenges. Mastering this skill involves recognizing these challenges and adopting strategies to improve accuracy. Here are the common challenges in pulse checking and how to overcome them:

1. Weak or Absent Pulse: Issue: Sometimes, especially in individuals with certain medical conditions or during emergency situations, the pulse may be weak or even absent.

• Solution: Adjust the pressure applied to the pulse point. If no pulse is felt, reposition your fingers and try again. Additionally, seek professional medical assistance promptly.

2. Inconsistent Beats: The pulse may exhibit irregular beats, making it challenging to get an accurate count.

• Solution: Extend the counting time to a full minute, especially if irregularities persist. This can provide a more comprehensive picture of the pulse rate.

3. Pulsatile Masses or Vibrations: In some cases, pulsatile masses or vibrations near the pulse point can create confusion.

• Solution: Be attentive to the location of the pulsation. If unsure, move to a different pulse point. In situations where there's doubt, seek professional medical advice.

4. Noisy Environment: External noise in a busy or chaotic environment can interfere with accurate pulse checks.

• Solution: Move to a quieter area if possible. If using a stethoscope, ensure a proper seal to minimize external noise.

Quick Tips for Enhancing Accuracy:

• Apply Steady Pressure: Ensure a uniform and soft pressure when locating the pulse. Too much pressure can compress the artery, affecting the accuracy of the reading.
• Use the Right Fingers: Use your index and middle fingers for palpation. The thumb has its own pulse, and using it can lead to confusion.
• Practice Regularly: Regular practice improves your skill in pulse checking. Familiarize yourself with the normal feel of a pulse to better recognize irregularities.
• Be Mindful of the Environment: Choose a calm and well-lit environment for accurate pulse checks. Minimize distractions to ensure focus.
• Adapt to Different Pulse Points: Depending on the situation, be adaptable in choosing the pulse point. Different locations may be more suitable, especially in diverse age groups.

Pulse Checking Tools and Technology

With technological advancements, pulse checking now extends beyond manual methods, incorporating tools such as pulse oximeters and smartphone apps. These aids offer convenience and additional features, but their reliability is contingent upon adherence to certain guidelines.

1. Pulse Oximeters

Pulse oximeters operate on the principle of photoplethysmography (PPG). These devices emit light through the skin, typically in the red and infrared spectrum. Hemoglobin in the blood absorbs varying amounts of light depending on the oxygen saturation level. The oximeter detects the transmitted and reflected light, allowing it to calculate both oxygen saturation (SpO2) and heart rate.

Pulse oximeters are particularly valuable for individuals with respiratory conditions, such as chronic obstructive pulmonary disease (COPD), asthma, or COVID-19. These devices offer a quick and non-invasive way to monitor oxygen levels and heart rate, enabling timely interventions or adjustments to oxygen therapy.

How to use pulse oximeters?

To use a pulse oximeter, attach its clip or probe to a peripheral area, typically the fingertip. The device shines light through the skin, with a sensor detecting it for real-time measurements. The fingertip is a popular location due to its accessibility and the concentration of blood vessels.

2. Mobile Applications

Mobile applications designed for heart rate monitoring utilize the smartphone's camera and flash. The camera captures variations in blood flow by detecting changes in the color of the skin, especially at the fingertip. As blood pulses through the vessels, it modulates the amount of light absorbed by the skin, allowing the app to calculate heart rate.

Heart rate monitoring mobile apps provide an easy-to-use and accessible method for tracking heart rate patterns over time. They are particularly convenient for regular monitoring, providing quick snapshots of heart rate variations in different situations. These apps are popular among individuals interested in maintaining general health and fitness, allowing them to incorporate heart rate data into their overall wellness strategies.

How to use a heart rate monitoring app?

Using a heart rate monitoring app is simple and convenient. Users typically place their fingertip over the smartphone's camera lens, ensuring that the flash is turned on. The app then processes the variations in light absorption to derive the heart rate. Some apps may require the user to remain still during the measurement for increased accuracy.

Dos and Don'ts When Using Technology Aids

Dos:

• Follow Manufacturer Guidelines: Follow the usage instructions given by the manufacturers of pulse oximeters or heart rate apps.This ensures accurate readings and optimal performance.
• Check Battery and Calibration: Regularly check your device's battery level, and if applicable, follow calibration recommendations. Low battery or improper calibration may affect accuracy.
• Understand Limitations: Understand the limitations of these technologies. Factors like nail polish, poor circulation, or certain skin conditions may impact their accuracy.
• Regular Maintenance: Keep your devices clean and well-maintained. Clean sensors and check for any visible damage that might affect readings.
• Use in Conjunction with Manual Checks: While technology aids are convenient, use them in conjunction with occasional manual pulse checks. This cross-verification ensures consistency and reliability.

Don'ts:

• Over-Dependence: Don't rely solely on technology. Regular manual pulse checks are essential for a comprehensive understanding of your health.
• Ignore Warning Signs: Don't disregard warning signs or symptoms, even if technology indicates normal readings. Seek professional medical advice if you have concerns.
• Assume Universal Accuracy: Don't assume that all pulse oximeters or apps are equally accurate. Research and choose reputable products for more reliable results.
• Disregard Individual Variances: Don't disregard individual variances. Factors such as age, skin tone, and medical conditions can impact the accuracy of these tools.
• Neglect Calibration Recommendations: Don't neglect calibration recommendations. Proper calibration is crucial for accurate readings.

How can you tell if you're checking the pulse correctly?

You can tell if you’re checking the pulse correctly if you feel a steady, rhythmic beat under your fingertips. When checking on your wrist, ensure your fingers are placed just below the thumb at the inner wrist. For the neck, your fingers should be positioned just under the jawline, next to the windpipe. The pulse should feel like a light but distinct tapping. If you don’t feel anything, try adjusting your fingers slightly or pressing a bit more firmly but gently. When you find the pulse, count the beats over a set period (like 30 or 60 seconds) to confirm a consistent rhythm and get an accurate reading.

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How Can CPR Training Improve Accuracy in Checking Pulse?

CPR training improves your ability to accurately check a pulse by teaching you the correct pulse points, how much pressure to apply, and how to recognize regular and irregular heart rhythms. These skills are crucial for determining if CPR or AED intervention is needed during an emergency.

Get CPR and AED certified online with CPR Select and be prepared to make a difference when it matters most!

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