How to find and assess a pedal pulse
Updated on January 14, 2015
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:
Radial pulse first
Assess the patient's radial pulse rate and rhythm so you know what you are seeking.
Bare the skin
Move shoes, socks, tights, and anklets out of the way to expose the patient's skin.
Reposition to normal
Move, if not compromised by injury, the patient's foot towards the normal anatomical position.
Two possible positions to check
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).
Visualize skin for pulsation
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.
Use two or more fingers
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.
Try the other leg
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.
Mark the location
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.
Temp and color
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.