Pulse Monitoring and Characteristics

Study Notes

A pulse is a stroke/bump of blood flow on the walls of the aorta.
Approximately 60-70 ml of blood enters the aorta with each ventricular contraction (stroke volume).
Each stroke causes the aorta to distend to compensate for the increase in blood pressure.
This creates a pulse wave that travels rapidly to the distal ends of the arteries.
Every heartbeat generates a wave of blood causing pulsations through the arteries.
Pulse frequency is equal to heart rate (frequency of heart ventricle contractions).
Pulse can be felt (palpated) through the nerves in the fingertips, especially if the artery runs close to the skin and bone.
Peripheral pulse is measured in the periphery of the body.
Central/apical pulse is located at the apex of the heart.

Pulse rate (frequency), rhythm, and volume are indicators of circulatory status.
They provide information on the regularity of heartbeats and the effectiveness of heart contractions.
Heart rate is the number of times the heart beats per minute.

Age: Heart rate slows down with age.
Gender: After puberty, resting heart rate for males is generally slightly slower than females.
Physical Activity: Increases heart rate due to increased metabolic rate and oxygen demand.
Emotional Status: Stress, fear, and anxiety can increase heart rate and cause vasoconstriction.
Body Temperature: Fever increases heart rate to compensate for decreased blood pressure.
Blood Volume: Increased blood volume (hypervolemia) may increase heart rate, while decreased blood volume (hypovolemia) may increase it to transport more oxygen.
Drugs: Some drugs decrease heart rate (e.g., cardiotonics, antihypertensives, opioids), while others increase it (e.g., atropine, adrenaline).
Pathological Processes: Conditions affecting the heart, lungs, or nervous system can alter heart rate or rhythm (e.g., pulmonary diseases, cardiovascular diseases).

Peripheral pulse points include the temporal, carotid, brachial, radial, femoral, popliteal, posterior tibial, and dorsalis pedis arteries.
Central/apical pulse is located in the 5th intercostal space at the midclavicular line.
Different methods to measure pulse include palpation (feeling with fingers), auscultation (listening with stethoscope), and using a Doppler ultrasound device.

Regular pulse: Intervals between beats are equal.
Irregular pulse (arrhythmia/dysrhythmia): Intervals between beats vary in length or force.
Irregularity can be attributed to early, late, or missed heartbeats.

Pulse volume (amplitude/strength) reflects the amount of blood ejected from the heart with each heartbeat.
Factors influencing volume: strength of heart contractions, elasticity of blood vessels, and blood volume in the arteries.
Three-point scale used for measuring pulse volume: no circulation, small pulse, normal pulse, and large pulse.

Different pulse measurement methods are used depending on the patient's age and condition.
Infants and children (<2 years) may utilize apical pulse measurement, while older children and adults typically assess radial pulses or use other methods.
Pulse measurement can help determine the adequacy of peripheral blood flow.