December 07, 2009 Email Print CommentRegisterBookmarkRSSWhat's This

Everyday EMS by Greg Friese

Pedal Pulse Assessment

Locating a pedal pulse is part of the trauma patient assessment and performed before and after lower extremity splint application as well as long backboard immobilization. Locating a pedal pulse can be difficult even in healthy patients. Use these tips to find a patient's pedal pulse:

1) First assess the patient's radial pulse rate and rhythm so you know what you are seeking.

2) Move shoes, socks, tights, and anklets out of the way to expose the patient's skin.

3) Move, if not compromised by injury, the patient's foot towards the normal anatomical position.

4) Check for either the dorsalis pedis pulse (on the top of the foot) or the posterior tibial pulse (located behind the medial malleolus — the ankle bone).

5) For dorsalis pedis, first visualize because you might see the skin pulsating above the artery. If you are unable to see anything, hold two or more fingers lightly against the skin. Move up from the toes towards the leg until you locate the pulse.

6) For posterior tibial — on the medial side of the ankle — use two or more fingers. I find more pressure is needed to find this pulse.

If you are unable to find the pedal pulse on one leg, switch to the patient's other leg. Knowing the location of one pulse might help you find the other.

Once you have found a pedal pulse, consider using a ballpoint or felt pen to make a light mark at the pulse location to make reassessment easier. Finally, if the patient's foot is warm with normal color, it is adequately perfused.

What else works well for finding a pedal pulse? Why might a pedal pulse be absent or diminished? Share your thoughts in the comments area.