carotid pulse?

Jolie, BSN · Jan 5, 2005

Hello everyone!
I haven't posted in a while but I have a question ( I am always lurking, but usually don't post!).
I am doing a project for school (almost done...graduate Jan 12th ) and I can't think of the reasons or which situations would call for checking a carotid pulse. I know you don't check every pulse point during every assessment, and I am having a little trouble determining when you WOULD check the pulses that you usually don't. I hope that makes sense! I feel a little silly for asking, but oh well! Thanks is advance.
Anjie
P.S. I LOVE this board, it is full of such great infomation!

1. CPR

2. This one is just a guess...how about a patient with a hx of stroke or TIAs? Does the strength of a carotid pulse correlate with adequate blood flow to the brain in these patients?

sjt9721, BSN, RN · Jan 5, 2005

Remember A-B-C of CPR?

Carotid pulse check in an unresponsive person

(Early) congrats on graduation!

Hairstylingnurse · Jan 5, 2005

You could check the carotid during CPR. I don't know if that is what your asking but I was taught that in a cpr class.

LPN2be2005 · Jan 5, 2005

i guess i didn't think of the cpr one because i am doing a project that includes an assessment. she might be looking for abc's, but i am not sure. here is the project......

black~ assessment questios

green~ what i wrote

red~ what my instrutor wrote

pulses: rate/quality/site (if pulse point is omitted state why)

r: radial pulse~ 72, normal dorsalis pedis ~ 72 , normal. radial it is unnecessary to check all pulse sites if the radial and dorsalis pedis sites are easily felt (you could have a reason to check the carotid along with radial and pedal)

thanks!

lovingtheunloved, ASN, RN · Jan 5, 2005

I often check carotid pulses. I work with Alzheimer's patients, and many of them WILL NOT hold still long enough to get an accurate radial pulse. They're trying to fold things, or pull the stethoscope off my neck or whatever. So I check their carotid pulse.

sjt9721, BSN, RN · Jan 5, 2005

Hmmm...Yes, you could have checked the carotids, perhaps noting if they were even or if they were 'in sync' with the peripheral pulses. (I'm using the plural carotids but you know to always check them one at a time! :) )

I'm guessing you chose not to mention the carotids because if the BP were high enough to produce strong radial/pedal pulses then strong carotids would be a 'given'. Correct?

:balloons:

CritterLover, BSN, RN · Jan 6, 2005

how about patients that have had a carotid endartectomy? we usually check the temporal pulse on that side, but you could probably make a case for checking the carotid.

similar to code situations, you can estimate sbp by checking carotid, femoral, radial, pedal pulses.

LPN2be2005 · Jan 6, 2005

Thanks! These reasons are good. I may need to ask my intstructor exactly what she was thinking, but at least I'll have some ideas!

Anjie

LPN2be2005 · Jan 6, 2005

Hmmm...Yes, you could have checked the carotids, perhaps noting if they were even or if they were 'in sync' with the peripheral pulses. (I'm using the plural carotids but you know to always check them one at a time! :) )
I'm guessing you chose not to mention the carotids because if the BP were high enough to produce strong radial/pedal pulses then strong carotids would be a 'given'. Correct?
:balloons:

You guessed correctly! I never really thought of checking them during a general assessment if the radial and pedal pulses were strong.

begalli · Jan 6, 2005

If you think about the anatomy of the carotids, they are the only vessels that supply the head and neck. The right carotid is the result of the brachiocephalic bifurcating into the right subclavian and the r carotid. The left carotid arises from the left subclavian. The subclavians branch and branch and branch to supply the remainder of the body.

With this anatomy in mind, I would think that would would check the carotids to assess perfusion to the brain, head and neck since pulses (such as the radial and pedal) below the aortic arch is supplying the lower body only.

I usually don't assess the carotids with my fingers except for code situations. I use my stethoscope to listen for bruits that can be a sign of arterial narrowing which we all know can lead to stroke.

Maybe the answer is to assess for bruits? Bruits are a nursing school topic after all.