Arterial Pulse: Radial

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Arterial Pulse: Radial

To assess cardiac function. To assess state of health.

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Arterial Pulse: Radial

  1. 1. Arterial Pulse: Radial To assess cardiac function. To assess state of health.
  2. 2. Method Of Exam <ul><li>Simultaneously palpate both radial pulses. </li></ul><ul><li>Note the rate, rhythm, character, amplitude and compare both pulses. </li></ul><ul><li>Feel the pulse with one finger. </li></ul><ul><li>To evaluate character of pulse - compress brachial artery against humerus and let up part way to feel percussion and tidal peaks. </li></ul><ul><li>Raise the patient's forearm and feel for a bounding pulse by feeling with the flat of your palm. </li></ul>
  3. 3. <ul><li>Normal:   </li></ul><ul><li>Pulse is symmetrical, regular and between 60-90 per minute.  </li></ul><ul><li>You have to learn to appreciate the character and amplitude of the normal pulse. </li></ul>
  4. 4. Abnormal Finding <ul><li>Rate </li></ul><ul><li>Bradycardia: Less than 60/min (Myxedema, heart block, raised IC tension, obstructive jaundice) </li></ul><ul><li>Tachycardia: Faster than 100/min. (Sinus tachycardia, PAT, atrial flutter, ventricular tach) </li></ul>
  5. 5. <ul><li>Rhythm </li></ul><ul><li>Irregular: (Sinus arrhythmia, extra systoles, atrial fib, pulses bigemini) </li></ul><ul><li>Alternating weak and strong pulse: </li></ul><ul><ul><li>Pulses bigemini: Normal beat alternating with extra systole (Dig toxicity) </li></ul></ul><ul><ul><li>Pulses alternans: Normal beat alternating with low amplitude beat </li></ul></ul>
  6. 6. <ul><li>Amplitude </li></ul><ul><li>Slow small sustained ( Aortic stenosis) </li></ul><ul><li>Large bounding pulse: Water hammer pulse: (Aortic insufficiency, high output states, slow heart rates) </li></ul><ul><li>Double systolic peak: Bisferiens pulse (Aortic regurgitation) </li></ul><ul><li>Decrease in amplitude during inspiration: Paradoxical pulse Exaggerated in (Pericardiac tamponade, obstructive lung disease) </li></ul>
  7. 7. <ul><li>Compare </li></ul><ul><li>Missing or feeble on one side: (Prior cath, Takayasu's disease, subclavian steel syndrome) </li></ul>
  8. 8. <ul><li>Grading Pulse </li></ul><ul><li>4=Normal </li></ul><ul><li>3=Slightly diminished </li></ul><ul><li>2=About half </li></ul><ul><li>1=Barely palpable </li></ul><ul><li>0=Absent </li></ul>
  9. 9. Knowledge Base <ul><li>Surface anatomy of radial and brachial artery </li></ul><ul><li>Physiology of pulse </li></ul><ul><li>Diseases altering pulse characteristics </li></ul><ul><li>Cardiac arrhythmias </li></ul>
  10. 10. <ul><li>Resources: Bates, A Guide to Physical Exam . </li></ul><ul><li>“ Nurses Informations” </li></ul><ul><li>http://nursesinformations.blogspot.com </li></ul>

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