How to find and assess a radial pulse

This tip was originally posted April 9, 2009. It has been updated with new information.

I had a college professor whom, when he rested his hands behind his head, I could watch the radial arteries on his hands pulsate.

For most patients, finding their radial pulse is fairly easy. If you are having trouble finding a conscious patient’s radial pulse, try these tips:

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  • Move clothing, watches or jewelry out of the way.
  • Cock or extend the patient’s wrist to bring their radial artery closer to the surface.
  • Palpate the distal end of the radius; then draw two or three fingers towards the radial artery. Move a few fingers proximally as you lightly scan to locate the radial artery.
  • Palpate the base of the patient’s thumb; then draw two or three fingers proximally towards the radial artery.

If you are unable to find the radial pulse on one arm, switch to the patient’s other arm. Once you have found a difficult radial pulse, consider using a ball point or felt pen to make a light mark at the pulse location in order to make reassessment easier.

What else works well for finding a radial pulse? Why might a radial pulse be absent or diminished?

Share your thoughts in the comments area.

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