radial pulse

I'm a bit worried about this one as well. Some people are so hard to find it on. I feel the first beat and then look at the clock. We have to do a full minute...I wish we could do 30 secs and double it.

Yea we have to do a full minute as well. According to our NNAAP booklet, when counting a radial pulse for one minute, we must be within + or - 2 beats of the instructor.

I was taught that 30 seconds is okay as long as the heartbeat is regular.

What I do is look at my watch in 10 second intervals. As soon as I feel the pulse I start counting when it hits the next multiple of 10, and then simply stop counting after 30 seconds.

If it beats exactly at the starting second mark, and exactly at the ending second mark, then you should probably not count the last beat since that would artificially inflate the result. Otherwise you can count the "on the second" beat.

Remember to start looking for respirations while counting the pulse. You don't want to mess with the accuracy of that by taking your hand off of their wrist, writing that down, and then staring at their chest. Most people, in my experience, change their breathing pattern when thinking about it.

So ideally, it takes only a minute to get both a pulse and respirations. The patient should not be able to tell which you're doing or when you "switch." This usually means glancing at their chest/shoulders while taking the pulse, and looking away while counting respirations.

You can count respirations and pulse at the same time by putting your hand on your leg and pressing down a finger every time you see a breath, ie the chest rises, you press down your pinky. It rises again and you press down your ring finger... after 5 breaths you start over. Then at the end if it's the 3rd time you've gone through your hand and you're pressing down with your middle finger, you know it was 18 breaths without having to juggle 2 sets of numbers in your head the whole time (which is pretty much impossible).

Counting them independently seems easier to me. People tend to learn things well if you break it down into small steps. "First you take the pulse, then you take the respirations."

While purely hypothetical, I think if you ran a study using each method, I bet you would find your method has a higher degree of error. Remembering a number and then counting again seems easier than teaching someone to count two things at the same time.

The advantage of counting both at the same time is you could take both a pulse and respirations in 30 seconds. This could significantly speed up your day depending on how many you're supposed to be doing. For most people, I think doing both would only prove more difficult.