How to find and assess a pedal pulse

Finding 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. Assessing a pedal pulse is part of the ongoing assessment for a patient on a backboard or a lower extremity splint. During hospital care, nurses and CNAs, might need to find and document lower extremity circulation for bed-bound patients.

Locating a foot pulse can be difficult even in healthy patients. Use these tips to find a patient's pedal pulses:

1. Radial pulse first

Assess the patient's radial pulse rate and rhythm so you know what you are seeking.

2. Bare the patient's skin

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

3. Reposition the foot to normal

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

4. Two possible pedal pulse 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).

5. 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.

6. Use two or more fingers