Tips on finding a brachial pulse on a heavy partner...

BBFRN, BSN, PhD · Sep 2, 2004

If you have a Doppler available, you might want to try that.

ZootRN · Sep 2, 2004

Our instructor told us there will be a trouble of finding a bracial pulse on obese person. So ask your instructor, what steps you should follow. Doppler would be good, but we don't have it in our school.

Farkinott, RN · Sep 2, 2004

The way I find it if I can't palpate it is to partially inflate the BP cuff and use the stethescope. Then you can pinpoint it for the pulse if you need to. If you can rationalise that with your assessor then maybe they will accept it. Some things just ain't textbook easy!

good luck1

All_Smiles_RN · Sep 3, 2004

I'd been having the exact same problem! Couldn't find the brachial for the life of me. One of the lab instructors suggested hyperextending the arm of the person. Then the brachial pulse practically jumps out at you. Good luck!

...Jennifer...

KRVRN, BSN, RN · Sep 3, 2004

I've also found that you need to press down a little harder than you think with the brachial.

purplekath · Sep 3, 2004

It's tricky with some people isn't it? I got a good tip once that works pretty well - most pulses you can find between two little sinews. So if you dig fairly deep and squidge around a little till you feel two little boney little lines, then a little bit deeper than that should be the pulse.

Good luck!

PS: If it's really tricky, ask your teacher to find it for you....if she can find it, you'll always know where to start looking. If not, then at least she knows it's a tricky one and will go a little easier on you!

twarlik · Sep 3, 2004

One of the lab instructors suggested hyperextending the arm of the person. Then the brachial pulse practically jumps out at you.

This usually works for me. I suppose if the person is REALLY big, then no amount of hyperextension is going to help...

rebelmama7 · Oct 21, 2004

Speaking as the heavy partner, with deep veins to top it off, the only way for anyone in my group to get my pulse was hyperextension and pushing HARD. I actually stiffened up my arm by pushing up on my elbow with my other arm, and had red marks from everyones pressing (my lab instructor actually thought that I had a rash). Keep in mind-be grateful you have that heavy/difficult partner now, everyone im my group is much more confident about getting a pulse on people like me now that they have had practice.

cherokeesummer · Oct 24, 2004

And a large portion of the population is obese (me being one of them) so it is good practice!

caroladybelle, BSN, RN · Oct 24, 2004

No special tricks but you will face this in real life, many, many times.

Also practice getting a BP on an ankle (pedal) or a knee (popiliteal). If you get good hearing it there, you can hear it about anywhere.