What is the pulse and how do I check it?

‘Pulse’ is one of medical terminology that is best known. It is commonly recognised as heartbeat scale.

The pulse is a critical heart rate indicator. Combined with dizziness, an unusually slow pulse may signify shock and help to detect internal bleeding.

In contrast, a pulse that is too fast points to high blood pressure and cardiovascular problems.

With practice, taking your own pulse and other people’s ones is fast.

But what is the pulse, why is it important and how can the pulse be detected and measured best? This article provides clear guidance.

Important facts about checking your pulse

Here are a few key points to test your pulse. The main article includes more descriptions and supporting material.

• As the heart pumps, the arteries expand and contract. This is the pulse.
• The pulse is easiest to find on the wrist or neck.
• A healthy pulse is between 60 and 100 beats per minute (bpm).

What is the pulse?

The pulse is the expansion of the arteries. This expansion is caused by an rise in blood pressure each time the heart beats, pressing against the elastic walls of the arteries.

With the heart these expansions rise and fall in time as it pumps the blood and then rests as it refills. At other points on the body, the pulsations are felt, where wider arteries run closer to the skin.

Finding the pulse

Arteries converge at the wrist and neck close to the surface of the skin making the pulse especially easy to detect at these stages.

Here are the basic steps needed to get a pulse on the wrist. The radial pulse is defined as:

1. Turn one hand over, so it is palm-side up.
2. Use the other hand to place two fingertips gently in the groove on the forearm, down from the fold of the wrist and about an inch along from the base of the thumb.
3. When the position is right, you should feel the pulsation of your heart beat.

The pulse can also be detected on the neck in a similar way, using two fingers. Gently press each side of the windpipe into the soft groove.

This is the pulse running through one of the carotid arteries. These are the principal arteries which run from the heart to the head.

Less easy places to find a pulse are:

• behind the knees
• on the inside of an elbow when the arm is outstretched
• in the groin
• at the temple on the side of the head
• on the top or the inner side of the foot

The video below, presented by a nurse, explains how a pulse should be taken:

Recording the pulse

If you’ve found the pulse by following the above steps, keep it still and take the following steps:

1. Use a timepiece or watch with a second hand, or look at a clock with a second hand.
2. Over the course of a minute or 30 seconds, count the number of beats felt.
3. The number of pulses over a minute is the standard heart rate measurement. This can also be calculated by doubling the number of pulses felt over 30 seconds.
4. The pulse should be between 60 and 100 bpm.

Normal readings

In a normal interval between each contraction, the heart should beat continuously, so that the pulse will always be steady.

As a general rule, a resting heart rate for adults is 60 to 100 beats per minute ( bpm). Individuals with greater physical health should usually have higher heart rates than pepole who exercise less. For example, athletes may have a resting heart rate of just 40 to 60 bpm.

It is normal, however, that the heart rate varies in response to movement, activity, exercise, anxiety, excitement and fear.

If you feel your heart is beating out of rhythm or at an unhealthy speed of less than 40 bpm or more than 120 bpm, and this can be felt when taking a pulse, talk to a doctor about this.

You may also feel like your heart missed or “skipped” a beat, or there was an extra beat. An extra beat is known as ectopic rhythm. Ectopic beats are very normal, generally harmless and require no treatment whatsoever.

However, if there are concerns regarding palpitations or ectopic beats, please visit a doctor.

Heart rate monitors

Hospitals use monitors that can check the heart rate and the pulse.

If you use a home monitor, you should:

• check with your doctor that is has been validated
• take your blood pressure at the same time every day
• take several readings and record the results

A clinical development of recent years is the wide range of products for personal health monitoring now available on the consumer market.

Numerous devices can be connected to mobile phone software apps, and a number of wearables for health monitoring are available which combine hardware and software in one device.

The Food and Drug Administration of the United States (FDA) has a page listing some of the applications approved by the regulator for health products. This may be a good starting-point.

Devices which attach to mobile phone software apps are now available. These home-use tools provide both hardware and software. Some give readings equivalent to those of a machine with an electrocardiogram ( ECG).

Measuring a pulse is easy, and can give a useful indication of your health status.

When you have questions about the heart rate, talk to your doctor.