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Pedal pulses

Posted

Any tips on palpating pedal pulses. I am getting ready to graduate, and I find it hard funding a pedal pulse with out the Doppler. Not sure if there was some super secret way you nurses find it? lol. Any advice is greatly appreciated!

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

Specializes in SICU, trauma, neuro. Has 16 years experience.

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.

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

VivaLasViejas, ASN, RN

Specializes in LTC, assisted living, med-surg, psych. Has 20 years experience.

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

Specializes in Med-Surg, Emergency, CEN. Has 10 years experience.

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

Specializes in Emergency Department. Has 6 years experience.

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

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 15 years experience.

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

Specializes in ICU. Has 10 years experience.

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.

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

Specializes in Emergency Department. Has 6 years experience.

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.

Lennonninja, MSN, APRN, NP

Specializes in MICU - CCRN, IR, Vascular Surgery. Has 10 years experience.

Close your eyes while palpating. That's always helped me concentrate on finding the sensation when it's difficult to find.

firstinfamily, RN

Has 33 years experience.

Practice, practice, practice and knowing the anatomy. For a long time I took an illustrated picture of the location of the pedal pulse with me to the bedside to look at while I was trying to locate it. Usually I find it between the Great toe and second toe at the metatarsals area on slightly above the arch of the anterior foot. I always mark the spot with an X, and if I cannot find it after my "search" I will use a doppler. If you cannot find the pedal, can you locate the posterior tibial? I always try to find both to assess for circulation issues.

newohiorn, BSN, RN, EMT-P

Specializes in Acute care, Community Med, SANE, ASC. Has 8 years experience.

I remember having a lot of trouble finding them when I was a new nurse too! Had forgotten that until I saw your post. Now I can pretty much walk up to someone and know where they should be. It comes with time and practice. Feel pulses on every patient even when you don't think it's necessary. I will say I could do without the stupid socks with the tread on both sides of the foot getting in the way of my pulse palpation.