Checking an infant’s pulse can provide important information about their well-being. For infants, the brachial pulse, located in the upper arm, is a common and reliable site to assess their circulatory status. Developing the ability to accurately locate and assess this pulse is a valuable skill for caregivers to monitor an infant’s health.
Why and When to Check an Infant’s Brachial Pulse
Assessing an infant’s brachial pulse is useful when their overall condition is a concern, such as if they are unresponsive, experiencing difficulty breathing, or appear unwell. Checking the pulse helps determine the effectiveness of their circulatory system. The brachial pulse is also assessed during first aid situations, like evaluating the need for cardiopulmonary resuscitation (CPR) in an infant. This assessment guides decisions about whether interventions such as chest compressions are needed.
Locating the Brachial Pulse
To find the brachial pulse, position the infant on their back on a firm, flat surface, with their arm slightly extended to expose the inside of the upper arm. The brachial artery runs along the inner side of the upper arm. Gently feel along the inner part of the upper arm, just above the elbow crease, to locate a soft, pulsing sensation. A slight groove between the biceps and triceps muscles often indicates the artery’s location.
Step-by-Step Brachial Pulse Assessment
Once the general area is identified, use the pads of your index and middle fingers to gently press on the inner side of the infant’s upper arm. Avoid using your thumb, as it has its own pulse that could lead to an inaccurate reading. Apply gentle but firm pressure, just enough to feel the rhythmic beat without obstructing blood flow. Too much pressure can compress the artery, making the pulse difficult to detect, while too little pressure may not allow you to feel it.
After locating the pulse, count the beats for a specific duration. A common method involves counting the beats for 15 seconds and then multiplying that number by four to calculate the beats per minute. For a more precise reading, especially if the pulse feels weak or irregular, count the beats for a full 60 seconds. Maintaining a calm and quiet environment can improve accuracy, as infants are sensitive to their surroundings.
Interpreting the Brachial Pulse and Next Steps
A normal infant brachial pulse feels strong and regular. The normal resting heart rate for infants varies by age, generally falling within 80 to 160 beats per minute for infants aged 1 to 11 months. Newborns (0 to 1 month old) may have a slightly higher range, from 70 to 190 beats per minute. Factors such as activity, crying, or fever can influence an infant’s pulse rate.
If the pulse is absent, very weak, irregular, or significantly outside the typical range, it indicates a need for immediate attention. For instance, if an infant’s heart rate is below 60 beats per minute and they show signs of poor perfusion, such as pale or mottled skin, starting chest compressions may be necessary. If the infant’s pulse is concerning, or if you are unsure, contact a healthcare professional or emergency services promptly.