OSCEs Locating and Recording Pulses DONE Flashcards
- Why can you feel pulses at particular sites of the body?
- What is the radial pulse used for?
- What is the brachial pulse used for?
- What is the carotid pulse used for?
- What are the other pulses used for?
- You can feel a pulse at sites in the body where an artery can be compressed against a bone.
- The radial pulse is used for general purposes, as it is easily accessible
- The brachial pulse is used for the measurement of blood pressure
- The carotid pulse shows whether there is any cardiac output at all (if the peripheral pulses are weak
- The other pulses examined sequentially and bilaterally are useful in studying peripheral circulation.
What is the correct method for obtaining any pulse? (3)
- Make sure the limb is supported and relaxed or you will only feel the tendons twitching
- Explore with three or four fingertips (not the thumb) laid flat, side-by-side. Use only light pressure at first
- Feel for pulses on both sides (bilaterally) to make sure the circulation is the same on both sides of the body.
What 4 things do you assess about a pulse? Describe them.
- The pule rate: bpm counted over 1 minute (according to the nurses at Salford) or 2-3 minutes according to the physpharm book
- The rhythm: may be completely regular, show a regular variation, be intermittant or completely irregular.
- The character: a gentle swell, a sharp impact, or complex
- The volume: the amplitude and its regularity.
- Character and volume are best assessed at major pulse sites such as the carotid.
Describe how you take the radial pulse
- The patients upper arm should be beside the body, the forearm horizontal, either palm up or down
- Place your fingers around the wrist, supporting it.
- Your fingers should be at the radial border of the wrist
Describe how you take the brachial pulse
- The arm should be supinated (palm up) and extended to about 45degrees to the body. Place your hand under the elbow and take the weight
- Ask the subject to flex the elbow and identify the biceps tendon
- Tell the subject to relax again and place your hand just medial to the tendon
- You will need to press more firmly than when locating the radial pulse, especially if the arm is heavily muscled.
Describe how you take the carotid pulse
- Identify the sternocleidomastoid muscle from the top of the sternum to behind the ear
- Ast the subject to relax, with the neck slightly extended.
- Place your fingers between the muscle and the side of the larynx
- Do not press hard, and do not palpate both sides simultaneoulsy
Describe how you take the ulnar pulse
- The forearn should be supinated (palm up) and relaxed and supported as usual.
- Place your fingertips just medial to the flexor tendons at the wrist.
Describe how you take the Dorsalis Pedis pulse
- Dorsalis Pedis lies on the upper surface of the foot, lateral to the tendon that extends the big toe.
Describe how you take the Posterior tibial pulse
The posterior tibial pulse is just below and behind the medial malleous
What are the two pulses you can find in the feet?
The dorsalis pedis pulse on the upper surface of the foot, and the posterior tibial pulse just below and behind the medial malleous.
Describe how you would take the facial pulse
The facial pulse is located on the mandible (lower jawbone) on a horizontal line with the corners of the mouth.
Describe how you would take the temporal pulse
First palpate a bony prominence called the zygomatic arch (no 3 on picture). Use your index and middle fingers to feel the zygomatic arch in front of your patient’s ear, near the small pointed eminence of the ear. Then move your fingers slightly above it to feel the temporal pulse.
How might the heart/pulse rate alter with breathing?
The pulse rate can increase as you breathe in and slow down as you breath out - this is more common in younger patients.
