Assessing an Apical Radial Pulse Deficit

Assessing an Apical Radial Pulse Deficit

Equipment
■ Watch or clock with a second hand or digital readout.
■ Procedure gloves, if indicated.
■ Stethoscope.
■ Alcohol wipes.

Assessment
■ Determine why assessment of pulse deficit is indicated (e.g., digitalis therapy, blood loss, cardiac or respiratory disease).
■ Assess factors that may alter the pulse (e.g., activity and medications). Post-Procedure Reassessment
■ Be Safe! Look for trends.
■ The presence of any apical–radial pulse deficit is abnormal.

Key Points
■ Palpate and place the stethoscope over the apex of the heart (5th intercostal space in the midclavicular line).
■ Palpate the radial pulse.
■ Have two nurses carry out the procedure, if possibl one counting radial and one counting apical pulse.
■ Count for 60 seconds, simultaneously.
■ Compare the pulse rate at both sites; calculate the difference.

Documentation
■ Note and document:
■ The apical–radial pulse deficit (compare to previous findings).
■ Other measures of cardiopulmonary status (e.g., skin color) to identify a decline in the patient’s condition.

Assessing the apical radial pulse deficit