Pulse checking and heart rates

Why check a pulse?

 

If your casualty is unconscious then they will be unable to tell you how they feel therefore a pulse check can indicate if their condition is getting better or worse. It can also help you as part of the diagnosis procedure to establish what could be wrong with them. 

 

You may also be able to tell if they have a regular or irregular heart rhythm by checking your pulse. This is important because an irregular heart rhythm may be a sign you have a heart condition.

What is a normal heart rate?

A pulse can vary dependent on the person you are examining, it may increase during the day when doing normal activities and when exercising. When exercising the heart rate will increase. The attached picture will show the differences between heart rates. 

Occasional irregularities such as missed beats are common and usually nothing to worry about.

 

It's usually checked when you’re resting or especially when unconscious.

An adult when at rest should display a heart rate of between 60 -100 beats per minute so if you are checking their heart rate and it increases over 100 or drops below 60 then there is cause from concern. 

How to find a pulse

RADIAL PULSE

Place two fingers at the base of the thumb then move downwards to your wrist, press down firmly and you should be able to find the pulse.

The following video from the British Heart Foundation gives really useful instructions. 

BRACHIAL PULSE

The brachial pulse is, in my opinion, the easiest method to obtain the pulse. 

The following videop from EMTprep.com is really useful. 

CAROTID PULSE

Use the carotid artery to find a pulse.

The following videop from EMTprep.com is really useful. 

How to physically take a pulse

Using one of the techniques above you should follow these steps:

  1. Find the pulse

  2. You need to count the pulses

  3. You'll also need to count to a specific time, use a watch, counter on mobile phone or someone to count them for you quietly this then allows you to concentrate on and count the pulses. 

If you have counted 12 pulses with in ten seconds you can then times it by 6 (to get the one minute)  = 72 pulse per minute

You can alter the time to 15 seconds and times by 4 to get the 60 seconds (one minute). 

OXIMETER

Oximeters are very cheap and widely available from ebay and amazon and are a fantastic, easy and constant method of monitoring you casualty. 

Pulse oximetry is a test used to measure the oxygen level (oxygen saturation) of the blood. It is an easy, painless measure of how well oxygen is being sent to parts of your body furthest from your heart, such as the arms and legs.

A pulse oximeter is a small, lightweight device used to monitor the amount of oxygen carried in the body. This noninvasive tool attaches painlessly to your fingertip, sending two wavelengths of light through the finger to measure your pulse rate and how much oxygen is in your system.

 

Once the oximeter finishes its assessment, its screen will display the percent of oxygen in your blood coming from your heart—as well as your current pulse rate.

Simply fit the device over the finger and it will start to measure the oxygen levels within your blood. 

SpO

This is the casualties oxygen levels.

Normal oxygen level is 95% and above, less than85% indicates severe hypoxia issues. 

PR bpm 

This is the casualties heart rate, if when using this it starts to increase or decrease this could indicate something is not quite right. 

This device takes the guess work out of taking a pulse and allows for the continuous monitoring of your casualty. 

Pulse identification

RAPID, REGULAR AND FULL -                                                 Excertion, fright, fever, high blood pressure

RAPID, REGULAR AND WEAK -                                               Shock

SLOW -                                                                                       Head injury, drug use, poisons, cardiac problems

IRREGULAR -                                                                             Quite normal