Pedal pulses

shayandkaty · Sep 12, 2014

Would also like to point out that I can find them on myself, but dealing primarily with elder population, it's difficult to find them sometimes. I just know there must be some juicy "tricks of the trade" out there!

Here.I.Stand, BSN, RN · Sep 12, 2014

I practiced on myself and my husband. On patients if at first you only can find it w/ the doppler, note the exact spot and then feel w/ your fingers. Don't use too much pressure--it compresses the artery and you won't feel the same pulsing as if the blood flowed freely.

Also know that some people's pedal pulses ARE very weak, and are not palpable. When in doubt, get the doppler.

shayandkaty · Sep 12, 2014

Thanks!!

Twinmom06, ASN, APN · Sep 12, 2014

I tend to find them between the great and 2nd toe right where they meet the metatarsals.

Long Term Care Columnist / Guide · Sep 12, 2014

And if you do have difficulty finding PPs, when you do find them it's good to mark the spot with an X so it's easier for the next nurse. :)

I seldom had trouble finding PPs, but I had a terrible time with popliteal pulses on obese patients.

NurseOnAMotorcycle, ASN, RN · Sep 12, 2014

Use three fingers and cover the top of the foot for a broad feel, then narrow it down. When I find it, I always mark the spot with an X. Patients tend to think it's funny.

akulahawkRN, ADN, RN, EMT-P · Sep 12, 2014

Don't forget the anatomy of the ankle/foot. The dorsalis pedis artery is a continuation of the anterior tibial artery. Normally you might be able to start feeling it just lateral to the extensor hallucis longus tendon (big toe extension tendon) as they cross the ankle to the foot and it usually stays just lateral to that tendon for most of the length of the foot. I normally start feeling for the pedal pulse right near the head of the 1st or 2nd metatarsal, just lateral to that tendon. I can find it most of the time quite easily... but sometimes I do need the Doppler.

TheCommuter, BSN, RN · Sep 12, 2014

Pedal pulses sometimes cannot be palpated in some people.

For instance, I am 33 years old (not quite elderly), yet my pedal and posterior tibial pulses have never been palpable. Hence, nurses use the doppler to detect them on me.

RunninOnCoffee · Sep 13, 2014

I am usually pretty accurate about an inch to 2 inches above the second toe. For the time being I am working in a vascular surgeons office and I can tell you LOL with PVD have no palpable pulses. Even with a Doppler it is sometimes hard to locate. If they have an occlusion in the DPA the body will often form collateral flow to compensate and therefore eliminate the DPA pulse almost all together.

caliotter3 · Sep 13, 2014

I looked up the price of a Doppler since I have such trouble with pedal pulses. Unfortunately at those prices, one didn't become a part of my personal bag of goodies.

akulahawkRN, ADN, RN, EMT-P · Sep 13, 2014

This is true! Some people just don't have palpable pedal pulses. Heck, some people don't have Dopplerable pedal pulses. The same goes for the posterior tibial pulse. As long as signs of adequate perfusion are present, it just means that the body is using an alternate/collateral means of circulation.