Pulse
- For additional meanings of the word pulse please see pulse (disambiguation).
In medicine, a person's pulse is the throbbing of a person's arteries as an effect of their heart beat, which can be felt at the wrist and other places. The term is also used to denote the frequency of the heart beat, usually measured in beats per minute. In most people, the pulse is identical to the heart rate, unless some of the heartbeats are ineffective and only displace little blood (as happens in some arrhythmias); in this case, the heart rate can be (much) higher than the pulse.
Pulses are manually palpated with two fingers, generally the pointer and middle finger. The thumb must not be used because it has its own pulse that will be felt instead of the patient's pulse. The two fingers must be placed near to an artery in order to feel the blood pulsating through the circulatory system.
- radial pulse - located on the thumb side of the wrist (radial artery)
- carotid pulse - located in the neck (carotid artery)
- brachial pulse - located in between the bicep and tricep; frequently used in place of carotid pulse in infants, who have no neck (brachial artery)
- femoral pulse - located in the thigh (femoral artery)
- dorsalis pedis pulse - located on top of the foot (dorsalis pedis artery)
- medial malleolar pulse - located in the back of the ankle
- temporal pulse - located on the temple (temporal artery)
The ease of palpability of a pulse is dictated by the patient's blood pressure. If his or her systolic blood pressure is below 90, the radial pulse will not be palpable. If his or her systolic blood pressure is below eighty, the brachial pulse will not be palpable. If his or her systolic blood pressure is below sixty, the carotid pulse will not be palpable. Since systolic blood pressure rarely drops that low, the lack of a carotid pulse indicates death. It is not unheard of, however, for patients with certain injuries, illnesses or other medical problems to be conscious and aware with no palpable pulse.
A normal pulse rate for a healthy adult, while resting, can range from sixty to ninety beats per minute (BPM). While asleep, this can drop to as low as forty BPM and during strenuous exercise, it can raise as high as 200-220 BPM. Generally, pulse rates are higher for younger patients. A resting heart rate for an infant is as high as an adult during strenuous exercise, and can be even higher.
Checking the pulse has various other uses in medicine; decreased pulses can be a sign of giant-cell arteritis (GCA, in absent temporal pulse) and peripheral artery occlusive disease (PAOD, in absent or decreased limb pulses).
