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EMS Education Tips

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.

About the author

Greg Friese is Editor-in-Chief of He is an educator, author, paramedic, and marathon runner. Ask questions or submit tip ideas to Greg by e-mailing him at
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Dianne Baker Dianne Baker Saturday, February 18, 2012 6:26:24 AM good precise understandable directions...
Sandy McGregor Franck Sandy McGregor Franck Thursday, May 24, 2012 11:16:09 AM Good video site for checking pedal pulses Dianne
James Cranfill James Cranfill Thursday, May 16, 2013 11:05:49 AM an ER nurse told us today that a pedal pulse is palpated in a vein, not an artery. is she confused or what?
Thursday, September 19, 2013 8:35:07 PM pulses are only felt in arteries not veins....