The brachial pulse is the perceptible beat of the brachial artery, a significant blood vessel located on the inner side of the upper arm. This pulse point offers valuable information about heart rate and the body’s circulatory function. Assessing the brachial pulse is a fundamental skill in general health monitoring, serving as a reliable indicator of blood flow to the arm.
Locating the Brachial Pulse
The brachial artery is the primary blood vessel supplying the upper arm, elbow, forearm, and hand. It begins as a continuation of the axillary artery, originating from the armpit and shoulder region. The artery extends down the front surface of the arm to the cubital fossa, the indentation at the front of the elbow.
To locate the brachial pulse in adults, focus on the inner aspect of the arm, just above the crease of the elbow. The artery lies close to the skin’s surface in this area, medial to the biceps tendon. You can often feel a slight indent between the bicep and brachialis muscles, which helps pinpoint the location. Extending the arm slightly with the palm facing upward can make the pulse easier to find by opening the antecubital fossa.
For infants, the brachial pulse is found slightly higher on the arm, near the middle of the upper arm. Due to their smaller limbs and softer tissues, the pulse may be felt between the biceps and triceps muscles on the inner side of the arm. Infant pulses are often lighter and faster than those of adults, requiring a gentle touch.
Checking the Brachial Pulse
Once the general location is identified, palpate the pulse using the appropriate technique. Use the pads of your index and middle fingers, rather than the thumb, as the thumb has its own pulse that can interfere with an accurate reading. Place these two fingers gently on the skin over the brachial artery.
Apply light pressure until you feel the rhythmic pulsation of the artery beneath your fingertips. It may be necessary to adjust your fingers or apply slightly more pressure, especially if the pulse is faint or in individuals with more muscle tissue. Avoid pressing too hard, as excessive pressure can compress the artery and block blood flow, making it impossible to detect the pulse.
After locating the pulse and feeling a steady beat, count the pulsations. For a quick assessment, count the beats for 15 seconds and then multiply by four to estimate beats per minute. For a more precise measurement, particularly if the rhythm seems irregular, count the beats for a full 60 seconds.
Common Uses of Brachial Pulse Assessment
Assessing the brachial pulse serves various practical purposes in both routine health monitoring and emergency situations. Its accessibility makes it a frequently used pulse point. One common application is during the manual measurement of blood pressure, where the brachial artery is used to determine systolic and diastolic pressures.
The brachial pulse is particularly useful for assessing circulation in infants, especially those under one year old. In very young children, other pulse points like the carotid artery in the neck or the radial artery in the wrist can be challenging to locate due to their small size and delicate anatomy. The brachial pulse provides a more reliable and accessible site for checking an infant’s heart function.
In emergency scenarios, such as during cardiopulmonary resuscitation (CPR) for infants, checking the brachial pulse is the preferred method to determine if the heart is effectively circulating blood. If an infant’s pulse is absent or very slow (below 60 beats per minute with signs of poor perfusion), chest compressions are typically initiated.