patient prep vitals

Radial Pulse Measurement

The radial pulse is the pressure wave of each heartbeat felt at the wrist.

10 steps3 criticalLimit 2 minAlways tested

Steps

1Perform hand hygiene, introduce yourself, and identify the patient (for example by name and date of birth)
2Provide privacy and explain the procedure to the patient
3Seat the patient comfortably with arms and legs uncrossed; if the patient is lying down, note the position
4Critical stepAsk the patient to hold the palm up and find the radial pulse on the thumb side of the wrist, just inside the radial bone
5Use the pads of your index and middle fingers; never use your thumb
6Critical stepPress gently until you feel the pulse best, adjusting pressure or finger position if you cannot find it
7Count the pulse for a full 60 seconds with a watch or clock that has a second hand
8Note the rate in beats per minute, the rhythm (even or irregular) and the force
9Critical stepCheck that the patient is comfortable and perform hand hygiene
10Document the pulse with the patient's position, and report an irregular rhythm or an adult rate outside 60 to 100 to the nurse or provider per facility policy

Tips

Never use your thumb to take a pulse: it has its own pulse and you may count your own heartbeat
The normal adult resting pulse is 60 to 100 beats per minute; report an adult rate outside that range
Pressing too hard can make the pulse disappear and pressing too lightly can miss it, so adjust pressure and finger position

Using the thumb and counting your own pulse.
Pressing too hard (the pulse can vanish) or too lightly (you miss it).
Counting for a short time on an irregular pulse, which can hide the irregularity.
Not documenting position or rhythm along with the rate.

Practice this skill

Practise the sequence with critical-step highlighting and a rationale for each step.

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Sources and how we check them: How we verify.