assessment assistance dorsalis pedis

SaderNurse05, BSN, RN · Nov 10, 2005

Like everything else in nursing, practice is the best way to learn this skill. When I started on a telemetry unit I was worried because up until then I found the dorsalis pedis easily on about 50% of my patients- now (many pulses later) I am about 90%. One thing you can do is practice on your family and friends- sounds strange but the more relaxed and confident you are the better it will be. Also, if you don't feel it at first try a lighter touch. Sometimes you can press so hard that you can't feel the pulse. Remember some may not have a pulse there due to vascular disease, so try a doppler.

kazmomRN · Nov 10, 2005

Just a note, if you have to use a doppler to find the pulse, please mark it for the next person following you, especially if it was hard to find.

That is just a huge pet peeve of mine for the previous nurse to tell you how hard the pulse was to find, but they do not mark it, so then I have to spend time to refind it.

Barb

Super_RN, BSN, RN · Nov 10, 2005

You've got good advice! Start out with light touching. This may sound simple, but don't use your thumbs. It's easier to mistake your pulses for the patients. Practice makes perfect!!:balloons:

Tiny1Nisolet · Nov 10, 2005

Thanks guys! I knew I could count on you. We talked a bit about this a clinical yesterday and I know it is not just me. Last night when we came home, I practiced on my kidos. I think I will keep up the practice over the weeked and see if that makes a difference for me. One of my issues may have been that I was pressing too hard. I will try a lighter touch! Thanks again!

Indy, LPN, LVN · Nov 10, 2005

Okay. First of all, the very best spot for me to feel a pedal pulse is the middle fingers of each hand, not the tips, more like in the middle behind the tips of these fingers.

That being said, do you always feel a radial pulse without mashing on it some? No? Especially those weak and thready ones...see where I'm going with this? I lay the finger down where it should be. If nothing I move with a light tough up and down the foot, slowly, provided it doesn't tickle unbearably. Then I start mashing and letting up, where it should be. Also, make sure the patient isn't pointing their toes on purpose or flexing their feet too much. Just have 'em keep a nice neutral position. For very weak ones I have to do this for both feet at the same time, and I gotta look at the ceiling sometimes while doing it. If it wasn't in a spot that made sense to me, I might go ahead and mark it for the next person, and definitely report off that it was a weak pedal pulse.

If you really have problems with this skill, just practice on your family and /or willing classmates.