A peripheral pulse is the rhythmic expansion and contraction of arteries located away from the heart, often felt close to the body’s surface. This palpable wave is generated as the heart pumps blood, causing arterial walls to distend. Assessing these pulses provides insights into heart activity and blood flow to the body’s extremities, serving as an indicator of cardiovascular health.
Locating and Measuring Peripheral Pulses
To locate the radial pulse, position your index and middle fingers on the underside of the wrist, just below the base of the thumb. Apply gentle yet firm pressure between the wrist bone and the flexor tendons until you feel a pulsation. This location is frequently used for quick heart rate checks due to its easy accessibility.
The carotid pulse is found on either side of the neck, just below the jawline and beside the trachea. Use two fingers to gently press in this soft, hollow area. Never palpate both carotid arteries simultaneously, as this could reduce blood flow to the brain.
For the brachial pulse, extend the arm with the palm facing upward. Locate the pulse on the inside of the arm, within the antecubital fossa, the triangular area in front of the elbow. This site is useful for measuring blood pressure and for checking the pulse in infants during cardiopulmonary resuscitation.
The femoral pulse is situated in the groin area, just below the inguinal ligament, where the thigh meets the torso. Since this artery lies deeper, more pressure is typically needed to palpate it compared to the radial or carotid pulses. This location is important for assessing circulation in the lower extremities.
To find the popliteal pulse, flex the knee slightly and place both hands behind the knee in the diamond-shaped popliteal fossa. This artery is relatively deep, and bending the knee helps in its detection. It provides insight into blood flow to the lower legs and knee area.
The dorsalis pedis pulse is located on the top of the foot, in the first intermetatarsal space, on the side of the tendon that extends the big toe. Following the tendon can help locate it. This pulse is useful for evaluating circulation to the foot.
The posterior tibial pulse can be found on the inner aspect of the ankle, just behind and below the medial malleolus, the prominent ankle bone. Place two fingers between the medial malleolus and the Achilles tendon and press down with moderate pressure.
Once a pulse is located, use the pads of your index and middle fingers to count the beats. Apply enough pressure to feel the pulse clearly, but not so much that you obstruct the blood flow. To determine the beats per minute, count the pulsations for 15 seconds and multiply that number by four, or for greater accuracy, count for 30 seconds and multiply by two, especially if the rhythm feels irregular.
What Your Peripheral Pulse Reveals
The pulse rate is the number of heartbeats per minute. For healthy adults, a normal resting pulse rate is 60 to 100 beats per minute. Well-trained athletes may have a lower resting heart rate, sometimes as low as 40 to 60 beats per minute, without indicating a problem.
Pulse rates vary with age:
- Newborns (birth to 4 weeks): 100-205 beats per minute (awake)
- Infants (1 to 11 months): 100-180 beats per minute
- Children 1-2 years: 80-130 beats per minute
- Children 3-4 years: 80-120 beats per minute
- Children 5-6 years: 75-115 beats per minute
- Children 7-9 years: 70-110 beats per minute
- Adolescents (13-18 years): 60-100 beats per minute (similar to adults)
A pulse rate above 100 beats per minute in adults is known as tachycardia and suggests conditions like infection, dehydration, fever, pain, anxiety, or thyroid disorders. Conversely, a pulse rate below 60 beats per minute is termed bradycardia, which can be normal for athletes but can indicate a heart condition or be influenced by certain medications.
The rhythm of the pulse provides information. A normal pulse has a regular rhythm. An irregular rhythm, where beats occur unevenly, suggests premature beats or conditions like atrial fibrillation.
The strength or amplitude of the pulse offers clues. A strong or bounding pulse indicates increased arterial pressure, while a weak or thready pulse suggests reduced blood flow or decreased cardiac output. A pulse that is difficult to locate indicates blockages within the artery.
Physical activity increases heart rate as the body demands more oxygen. Emotions such as stress or anxiety also elevate the pulse. An individual’s age, biological sex, overall health status, body temperature, and certain medications affect the pulse rate.
When to Seek Medical Advice
If you consistently observe a pulse rate outside normal ranges (above 100 or below 60 beats per minute for adults), seek medical advice. Any persistent irregularity in the pulse rhythm, such as a skipping or erratic beat, requires evaluation.
Consult a healthcare professional if your pulse feels very weak, thready, or is absent in a location where it was previously palpable. If an abnormal pulse is accompanied by other concerning symptoms, such as dizziness, chest pain, shortness of breath, cramping in the legs during walking, extreme sensitivity or numbness in the legs, or one leg feeling noticeably colder than the other, seek prompt medical attention. Self-assessment of peripheral pulses provides general information, but it is not a substitute for a comprehensive medical diagnosis by a qualified healthcare provider.