i am having a hard time taking newborns apical pulses. i start ok but then i get fuster around 15 secs in and lose my count because there heart rate is so fast. i am asking for help from experience ob nurses on trick of the trade. this is my only vital sign i struggle with.
Feb 24, '06
We are asked by our peds and NNP to do 1 minute apical pulses on all newborns, particularly on the initial shift assessment, on newborns with known murmurs or irregular rhythms, and other problems, and initially at birth. What helps me is:
Having a good quality pedi stethoscope; this is so important esp if you are inexperienced at auscultating newborn heart beats.
As quiet an environment as possible---dont' be afraid to let visitors/others know you need a minute to listen to the baby; it's that important.
I have sometimes tapped my finger on the crib or another surface, to the beat of the heart, if its very fast---this somehow helps me stay on track well. It's really important you know the rate, rhythm and sounds of the baby's heart-----tapping helps you see how regular that really is.
I am sorry, but you really cannot often pick up murmurs and other abnormal sounds/rhythms with just 15 seconds oftentimes; try to do apical pulse auscultation for at least one minute on all babies every shift, and every time for kids who have audible murmurs or irregular rhythms.
With practice, it does get MUCH easier; you will be a pro soon.
Last edit by SmilingBluEyes on Feb 24, '06