A pulse is the rhythmic throbbing felt over an artery, caused by the surge of blood with each heartbeat. It indicates circulatory system function, providing insight into a person’s physiological state. Assessing the pulse is a routine healthcare procedure. This discussion focuses on two frequently used locations: the brachial and radial arteries.
The Brachial Pulse: Location and Application
The brachial artery is situated along the inner aspect of the upper arm, extending from the shoulder to the elbow. It runs medially to the biceps muscle and tendon, lying relatively close to the surface in the antecubital fossa, the triangular area on the anterior side of the elbow.
To locate, place two or three fingertips (index and middle) on the inside of the elbow, slightly above the joint crease and toward the midline. Apply gentle pressure to feel the pulsation against the underlying bone.
The brachial pulse serves a distinct role in clinical assessment, particularly for measuring blood pressure. A blood pressure cuff is inflated around the upper arm, temporarily compressing the brachial artery to stop blood flow. As the cuff slowly deflates, healthcare providers listen for the sounds of blood flow returning through the artery, which helps determine systolic and diastolic pressures.
This site is also important in infant cardiopulmonary resuscitation (CPR). For infants, the brachial pulse is a reliable site for checking circulation due to its accessibility and consistent palpability, making it a preferred location during emergencies.
The Radial Pulse: Location and Application
The radial artery is located on the thumb side of the wrist, running along the forearm. It lies superficially between the styloid process of the radius bone and the flexor carpi radialis tendon, making it readily accessible for palpation.
To find, place the index and middle fingers on the wrist, just below the base of the thumb and slightly to the side of the prominent tendon. Apply light, steady pressure against the bone to detect the pulse.
The radial pulse is widely used for routine pulse assessment in adults and older children because of its convenience. Its superficial location and the presence of underlying bone provide an excellent surface against which to feel the arterial pulsations. Healthcare professionals and individuals can quickly assess heart rate and rhythm at this site during routine physical examinations, or when monitoring a patient’s condition.
Comparing Brachial and Radial Pulses: When and Why Each Is Used
The choice between assessing the brachial or radial pulse often depends on the patient’s age and the specific clinical situation. For infants, the brachial pulse is generally preferred for pulse checks during emergencies like CPR.
This is because the brachial artery is larger and more easily located in their small limbs compared to the radial artery, which can be difficult to find reliably in an infant’s tiny wrist. Its accessibility makes it a practical choice for quickly determining if a baby has a palpable pulse.
Conversely, for adults and older children, the radial pulse is the most frequently used site for general pulse assessment. Its convenient location on the wrist allows for quick and unobtrusive checks of heart rate and rhythm in a variety of settings, from routine doctor visits to monitoring during recovery.
The brachial pulse’s primary application in adults is for blood pressure measurement, where a cuff is specifically designed to compress this artery. The unique anatomical position of the brachial artery, being the main conduit of blood flow to the lower arm, makes it ideal for this purpose, as its occlusion and subsequent release allow for accurate pressure readings.
In emergency situations involving severe shock or very low blood pressure, peripheral pulses like the radial pulse may become difficult or impossible to detect due to reduced blood flow to the extremities. In such cases, more central pulses, such as the carotid artery in the neck or the femoral artery in the groin, might be assessed to confirm the presence of circulation. While the brachial pulse is more reliable than the radial in infants, it can also be used in adults when peripheral pulses are not palpable. Carotid or femoral arteries are often the first choice for central pulse checks in adults.
Interpreting Pulse Characteristics
Beyond simply noting the presence of a pulse, healthcare providers assess several characteristics to gain a comprehensive understanding of circulatory function. The pulse rate, measured in beats per minute, indicates how fast the heart is beating.
A typical resting heart rate for adults ranges from 60 to 100 beats per minute. The rhythm of the pulse refers to the regularity of the beats; a regular rhythm indicates consistent intervals between beats, while an irregular rhythm suggests variations.
The strength or amplitude of the pulse also provides valuable information. A strong pulse indicates robust blood flow with each beat, while a weak or thready pulse suggests reduced blood volume or cardiac output. These characteristics collectively offer insights into the heart’s pumping effectiveness and the overall state of the circulatory system.