Peds vital signs

[gladysaw]

How do peds nurses measure the pulse of a baby manually? I tried to feel it over the radial or brachial area but babies' pulses are too fast to count! Help!

[albsRN]

It's best to get an infants apical pulse with your stethoscope. It helps if you can catch the baby while sleeping or see if parents or you can calm it before you try, then you won't have to try to listen with the crying. It's hard to count at first but you'll get the hang of it. Try tapping your finger with the rhythm of the heart beat to keep on track.

[gladysaw]

It's best to get an infants apical pulse with your stethoscope. It helps if you can catch the baby while sleeping or see if parents or you can calm it before you try then you won't have to try to listen with the crying. It's hard to count at first but you'll get the hang of it. Try tapping your finger with the rhythm of the heart beat to keep on track.[/quote']

Thank you for your advice! Im a student nurse at a peds hospital. Its been 2 months and i still find it hard to count the pulse of an infant manually! Especially when they start moving or crying!

[JustBeachyNurse, LPN]

Apical is the recommended method, definitely not radial. Brachial is used for a "pulse check". Listening to an apical pulse is still considered a manual pulse (as opposed to using a pulse-ox, cardiac monitor, or automated BP machine which would be automatic/machine/non-manual)

[KelRN215, BSN, RN]

Been a pediatric nurse for almost 6 years... never once checked a baby's pulse on the radial or brachial artery. Use your stethoscope and listen to their heart. It beats fast but definitely not too fast to count.

[JustBeachyNurse, LPN]

Just to clarify, by "pulse check" I'm referring to the steps during CPR not for a standard vital sign measurement....I can't imagine trying to count a pulse from a brachial artery on a wiggly infant/toddler. Even on my limited mobility patients it would be extremely difficult.

Actually in my new pediatric home health agency job it's against company policy to obtain a pulse other than apical during assessment. (and some of these kiddos have significant cardiac or respiratory issues they just happen to be able to have the technology to live at home)

[hiddencatRN, BSN, RN]

Another vote for apical to count the rate. I palpate brachial and/or radial depending on age while doing my cap refill checks but that is to assess for peripheral circulation not heart rate and it's more "is it there, does it feel normal? cool"