Anyone doing Apical/Radial anymore?

Nurses General Nursing


Remember learning to take an apical/ radial rate in school?.......2 nurses simultaneously counting the heart counting the apical while one counts the radial pulse....

Do any of you do this in practice? If so, what circumstances indicate this assessment is needed? Do you NEVER do it?

Thanks for your input!:cool:

What would be the indications for doing this? I have a small recolation of it, but never did it IRL.

ERNurse752, RN

1,323 Posts

I've never seen it...that's what heart monitors are for! hehehe

;) ;) ;)

I've done it very rarely. And usually it is something you do to show that this person really needs to be monitored. Or else on a DNR patient.



renerian, BSN, RN

5,693 Posts

Specializes in MS Home Health.

I have done is alot only with one person listening to apical and checking the radial pulses to see if they match. That is what I was taught to do on all patients in nursing school.



1,244 Posts

just a guess....

but if radial is less than apical, it means poor perfusion?


238 Posts

Specializes in Hospice and Palliative Care, Family NP.

It's a normal part of my daily assessment. it only takes a moment, and is important. I had a post op patient who had a large pulse deficiet and was transferred to a cardiac unit. He had new onset A-fib and did show other symptoms, dizziness etc, that other nurses dismissed as 'normal' with first time up after surgery. Glad I called the doc on it, few days later after meds did not work he was cardioverted.

It's the simple mundane and routine parts of an assessment that be the most important to our patients.


134 Posts

I work in home health. I always check apical pulses at the same time taking the radial pulse. I thought everyone did this?!?!?

Originally posted by KP RN

I work in home health. I always check apical pulses at the same time taking the radial pulse. I thought everyone did this?!?!?

But with two people at the same time???:confused:


37 Posts

I am also in home health, and I do it with every assessment as well. I just thought everyone did it, too! I have never seen 2 people doing it, tho.

Hellllllo Nurse, BSN, RN

3 Articles; 3,563 Posts

I have never been taught/learned about this.

Is this the same as checking for "widening pulse pressure"?

Please give us the rationale, and the indications for it, and what this is idicative of?

I am disturbed that I do not know about this and wish to remedy the situation!

Thank you.:imbar

boggle, ASN, RN

393 Posts

Specializes in Med-Surg.

Helllllo Nurse, ( did I miss an l??), pulse pressure is the differnce between the systolic and diastolic pressure

The Apical/Radial assessment must be done with 2 people. At the same time, one nurse counts apical and one nurse counts radial for a full minute. If the radial rate is lower than the apical rate, the number of beats difference is a the pulse deficit. ( apical 80, radial 78 = pulse deficit of 2.) Yes, it indicates perfusion problems.

I don't see how you can do this technique/assessment alone.

But, I also have OFTEN checked a radial as I have listened to an apical and noted beats that did not perfuse to the wrist. That is different than the A/R assessment.

I'm trying to determine if the full minute, 2 person A/R assessment described above is still being done in the real world. If so, when and why and in what setting?

This is still being taught in nursing schools. The students that I see struggle with this...not with the concept or the significance of the findings, .....but with the actual synchronizing of the timing and counting apical and radial rates.

So, what do you all think???

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