Measuring Radial Pulse — Practice Checklist

Step-by-Step Procedure (12 steps)

1. 1.

   Gather equipment: watch with a second hand (or digital timer), pen, and paper.

2. 2.

   Wash hands.

3. 3.

   Identify the resident and explain the procedure.

4. 4.

   Assist the resident to a comfortable sitting or lying position with the arm resting at heart level, palm up.

5. 5.

   Locate the radial pulse on the thumb side of the inner wrist using the pads of your index and middle fingers — never the thumb (your thumb has its own pulse).

6. 6.

   Apply gentle, firm pressure until you can feel the pulse clearly.

7. 7.

   Note the time on your watch and begin counting the pulse beats for a full 60 seconds.

8. 8.

   While counting, assess the rhythm (regular or irregular) and strength (strong, weak, bounding, thready).

9. 9.

   If the rhythm is irregular, always count for a full 60 seconds.

10. 10.

    Record the rate per minute, rhythm, and strength.

11. 11.

    Lower the resident's arm gently.

12. 12.

    Wash hands and report any abnormal findings to the nurse.

Evaluator Pass Criteria (4 checkpoints)

All of these must be observed for you to pass this skill.

• Index and middle fingers (not thumb) are used to locate the pulse.

• Pulse is counted for a full 60 seconds.

• Rate, rhythm, and strength are all assessed.

• Results are accurately recorded.

Critical Mistakes — Avoid These

• ⚠

  Using the thumb to count the pulse — your thumb has a pulse that will confuse the count.

• ⚠

  Counting for only 30 seconds and doubling — always count the full 60 seconds.

• ⚠

  Pressing too hard and obliterating the pulse, or too lightly to feel it.

• ⚠

  Forgetting to note rhythm and strength, not just the rate.

• ⚠

  Not resting the resident's arm at heart level before counting.