Hard Time Finding Brachial Artery

Nursing Students CNA/MA

Published

Hello all!

I started my CNA class mid-May and we're just now starting to learn how to take BPs.

What I've been having the most trouble with is finding the brachial pulse. If I'm lucky I can find it (it's usually very faint), but most of the time I can't feel anything. I'm using two fingers and I've tried varying levels of pressure--thinking that I was pressing too hard, or not hard enough---but I can't find any reason why I can't consistently find it.

Any tips? Anyone willing to tell me, step-by-step what they (personally) do to find the brachial pulse? My textbook (Mosby's) and teacher haven't been much help.

put your fingers (index and middle ) on the tip of you thumb and trace down until you reach the base of your thumb to your wrist .

Twix said:
put your fingers (index and middle ) on the tip of you thumb and trace down until you reach the base of your thumb to your wrist .

Wouldn't that be the radial pulse? I need to know how to find the brachial pulse (by the elbow).

1 Votes
zooz said:
Wouldn't that be the radial pulse? I need to know how to find the brachial pulse (by the elbow).

yup, that is the radial, ....make sure the arm is fully extended...prop the arm to maintain that position...start at the medial side of the elbow (closest to the body) and work across.....if that doesnt do it, try a little lower and try again...good luck

1 Votes

ooops sorry, lack of sleep...hehe...i read radial...

Specializes in LTC.

Odd thing I learned in A&P.

Follow the bicep down to where it turns into tendon about an inch or so above the crook of your arm, palpate the medial side you may have to kind of push the muscle over to find it.

In people who have extra fluff you may have to dig around a little to find the artery. Its buried in there.

Specializes in Neuro.
casi said:
Odd thing I learned in A&P.

Follow the bicep down to where it turns into tendon about an inch or so above the crook of your arm, palpate the medial side you may have to kind of push the muscle over to find it.

In people who have extra fluff you may have to dig around a little to find the artery. Its buried in there.

Good suggestion! I just found it on myself that way. Found it about an inch above my elbow and then kind of traced it down to the crook, where I'd put the steth.

1 Votes

Thanks for the help, everyone. Making sure that the arm is fully extended has helped a lot. I'm still having some trouble finding the brachial pulse every time, but it seems to be getting easier.

Thanks again. If anyone has any other tips on finding this sneaky pulse, let me know.

Carolyn (ginger58) was kind enough to send me this PM and I thought I would share it because it clarifies everything nicely:

ginger58 said:
To be sure you understand medial, you need to know that anatomic position is with the palms forward and medial is toward the center. So you're looking for this devious pulse on the side of the 5th finger.

Take your right index and third fingers and at or slightly below the crease at your left elbow roll your fingers over the bone and it should be there. Try pressing with less pressure. It also helps to roll the fingers over the bone and then flatten them out instead of trying with the finger tips.

Hope this helps. It's tricky. Carolyn

1 Votes

i find the easiest way to find the brachial pulse is if i draw a straight line from my litle finger up to my elbow crease. i end right on top of it.

All this time I was having a horrible time finding the brachial on anybody, then suddenly today my instructor whips out this little gem:

extend your arm (resting)

with the opposite hand, place the index finger squarely in the middle/center of the crease

now add the next two fingers.

now lift your index finger.

it may take a moment, but you should feel your brachial.

1 Votes
Specializes in LTC.

I remember learning in class that we had to find the pulse so we could put the stethoscope right on top of it, but in practice I put the steth wherever it LOOKS like it should go, and I never have trouble hearing.

+ Add a Comment