Pulse Monitoring and Heart Rate Overview

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 heart contraction (stroke volume).
Each heartbeat creates a pulse wave that travels quickly to the ends of the arteries.
Pulse rate equals heart rate.
Pulse can be felt (palpated) by placing fingers over a major artery near the skin, especially if the artery runs across a bone.
Types of pulse: peripheral and central.
Peripheral pulse is measured in the periphery of the body.
Central/apical pulse is located over the heart's apex.
Pulse characteristics (rate, rhythm, volume) indicate circulatory health and heart rhythm regularity.

Heart rate is the number of heartbeats per minute.
Factors affecting heart rate: age, gender, physical activity, emotional state, body temperature, blood volume, medications, and pathological processes.
After puberty, males generally have a slightly slower resting heart rate than females.
Physical activity increases heart rate due to increased metabolic rate and oxygen/nutrient demand at the cellular level.
Emotions (stress, fear, anxiety, excitement) trigger the sympathetic nervous system, increasing vasoconstriction and the metabolic rate, force, and rate of the heart.
Fever increases heart rate to compensate for lower blood pressure caused by vasodilation.
Blood volume increase (hypervolemia) or decrease (hypovolemia) can influence heart rate.
Medical conditions (e.g., cardiac or respiratory diseases) or neurological dysfunctions can change the heart rate.

Peripheral pulse points are locations where pulses are easily felt.
Easily accessible arteries include the temporal, carotid, brachial, radial, femoral, popliteal, dorsalis pedis.
Central (apical) pulse location is at the apex of the heart.
Specific locations for measuring the apical pulse for infants and children less than 2 years.
Sites for measuring the apical/central pulse depend on the patient's age.

Palpation: feeling the pulse in an artery.
Auscultation: using a stethoscope to listen to the heart sounds and determine the rhythmic properties of the pulse.
Doppler method: using an ultrasound device to detect the pulse by examining blood flow.
Oscillometric method: using a digital blood pressure monitor to detect variations in pressure in the artery when blood flows pass.
Blood pressure measurement methods (direct/indirect) methods include:
- Direct: arterial catheter to measure blood pressure directly.
- Indirect: sphygmomanometer which combines a cuff and a manometer to measure arterial pressure by palpating and listening to sounds.