The pulse is a simple, non-invasive measurement reflecting the number of times a child’s heart beats each minute, known as the heart rate. Learning how to accurately check a child’s pulse provides caregivers with a fundamental skill for monitoring well-being. This ability helps establish a baseline when the child is healthy and is important for recognizing changes during illness or an emergency.
Locating the Pulse and Counting Technique
The location used to find the pulse depends on the child’s age, as certain arteries are easier to palpate in different body sizes. For infants, the most reliable location is the brachial artery, found on the inside of the upper arm between the elbow and the shoulder. For older children, the radial artery on the wrist, located on the thumb side, is the easiest and most accessible site for a routine check. The carotid artery on the neck is another option, although pressure should only be applied to one side at a time to avoid restricting blood flow to the brain.
To check the pulse, use two fingers, generally the index and middle fingers, to apply gentle pressure over the artery. Avoid using the thumb, as it has its own noticeable pulse that can lead to an inaccurate count. Once a steady throbbing sensation is felt, the counting process should begin while the child is resting quietly for at least five minutes.
For a quick estimate, count the beats felt for 15 seconds, then multiply that number by four to calculate the beats per minute (bpm). For the most precise measurement, especially if the rate seems irregular or unusually slow, it is best to count the beats for a full 60 seconds. Counting for a full minute helps account for natural variability or slight irregularity in the rhythm.
What is a Normal Pulse Rate
A child’s normal heart rate varies significantly based on their age and current state of activity, with rates being higher in younger children and decreasing as they get older. A resting heart rate is measured when the child is calm and still, and it will naturally be slower than when they are active, stressed, or sick. Newborns and infants have the fastest heart rates because their hearts are smaller and must pump more frequently to circulate blood.
For example, a newborn from birth to one month old can have a resting heart rate ranging from 70 to 190 beats per minute (bpm). Infants from one to 11 months old typically fall between 80 and 160 bpm. Toddlers aged one to two years old will generally have a rate between 80 and 130 bpm.
As children enter the preschool and school-age years, their resting heart rates continue to decrease. A five to 12-year-old generally ranges from 70 to 120 bpm. Adolescents, 12 to 18 years old, have a resting rate similar to that of an adult, falling between 60 and 100 bpm. These ranges provide a guide for what is considered healthy, but caregivers should also know their child’s individual resting baseline.
When to Seek Medical Attention
While fluctuations in heart rate are normal, certain signs warrant a prompt medical evaluation. A pulse rate consistently outside the normal range for the child’s age, whether too slow or too fast, should be discussed with a healthcare provider. A rate that is difficult to count or feels erratic and unsteady could signal an irregular heart rhythm requiring attention.
Immediate medical attention is necessary if an abnormal pulse rate is accompanied by other concerning symptoms. Serious indicators include chest pain, dizziness, or fainting. Difficulty breathing, such as muscles pulling in between the ribs, or a change in skin color like paleness or blue lips, also require immediate care. If a child is injured and the pulse cannot be located quickly, or if they are unresponsive, contact emergency services immediately.