How do you check a pulse? Nope I'm not a student

Hello all, recently a few of us gals got onto the subject of taking a patients pulse. The earliest fundamentals of nursing taught so long ago. No I'm not a student, relax. I never really watched or noticed the way anyone else checks a pulse. So what I found is that all three of us did this somewhat differently. Wrist up, wrist down, and relaxed by patient's side or a variant somewhere in between. How do YOU typically check a pulse?

[Aeterna, BSN, RN]

I don't really care about the position of the arm, but I was taught a little trick that it's easier to palpate the radial pulse if the hand is flexed slightly. That way, it's easier to feel for that little hollow where the pulse seems to feel strongest. However, if I'm not sure or it's still difficult to palpate, I'll whip out my stethoscope and listen to the person's heart with one hand while feeling the pulse with my other hand.

[nursel56]

Wrist up with the arm in a resting position, although when I worked in a clinic sometimes they held their arm out. If I couldn't feel a pulse right away I might switch to the other side or re-position their arm. Usually didn't need to take an apical pulse there.

[dudette10, MSN, RN]

Counting a pulse? Radial, all four of my fingers wrapped around the radius into the groove where the artery is, pushing down gently as to not occlude the vessel and lose the pulse all together.

Checking for a pulse? Carotid. Although I learned it in BLS, I'll always remember that because an RRT doc once yelled at a nurse who checked for the pulse on an unresponsive patient at the radial artery.

[newtress, LPN]

Oh lord.

[nursel56]

Oh lord.

Whaaaaaat??? I'll have you know every one of my radial pulse patients lived to see the next day.

[BrandonLPN, LPN]

Let's be honest, the vast majority of routine pulses are gotten with a pulse-oximeter.

[hiddencatRN, BSN, RN]

Pulse ox or apical or brachial or rarely radial. I hold my hands like I'm checking a radial pulse while counting respirations to fake my patients out so they're not doing funny things with their breathing.

[FORTHELOVEOF!!!!]

I can't rely on pulse ox or the pulse that my blood pressure machine gives because 95% of the patients on my floor have A-fib, I usually just do a radial in whatever position they happen to be in.

[K+MgSO4, BSN]

It's like tying your shoelaces.

It doesn't matter how you do it as long as you can feel the pulse.

[newtress, LPN]

Love all the replies!

[Elladora]

Pulse ox if I'm standing at the med room AND it's readily available AND the client cooperates AND the machine picks up their reading. Otherwise, however I can get ahold of their wrist long enough to let me check it. (I work in Mental Health and am an EMT on the side)