What is the pulse and how do I check it?
The pulse is a crucial measure of the heart rate. An extremely slow pulse combined with dizziness can indicate shock and help identify internal bleeding.
A pulse that is too quick, on the other hand, points to high blood pressure and cardiovascular problems.
With practice, it is easy to take your own pulse and those of other people.
But what is the pulse, why is it important, and what is the best way to find and measure the pulse? This article gives straightforward guidance.
Here are some key points about checking your pulse. More detail and supporting information is in the main article.
- As the heart pumps, the arteries expand and contract. This is the pulse.
- The pulse is easiest to find on the wrist or neck.
- A healthy pulse is between 60 and 100 beats per minute (bpm).
What is the pulse?
These expansions rise and fall in time with the heart as it pumps the blood and then rests as it refills. The pulsations are felt at certain points on the body where larger arteries run closer to the skin.
Finding the pulse
Take the wrist pulse for an easy way to monitor heart rate.
Arteries run closely to the surface of the skin at the wrist and neck, making the pulse particularly easy to find at these points.
Here are the simple steps needed to take a pulse at the wrist. This is known as the radial pulse:
- Turn one hand over, so it is palm-side up.
- Use the other hand to place two fingertips gently in the groove on the forearm, down from the fold of the wrist and about an inch along from the base of the thumb.
- When the position is right, you should feel the pulsation of your heart beat.
The pulse can also be found on the neck using two fingers in a similar way. Gently press into the soft groove on either side of the windpipe.
This is the pulse running through one of the carotid arteries. These are the main arteries that run from the heart to the head.
Less easy places to find a pulse are:
- behind the knees
- on the inside of an elbow when the arm is outstretched
- in the groin
- at the temple on the side of the head
- on the top or the inner side of the foot
The video below, presented by a nurse, explains how to take a pulse:
Recording the pulse
Once the pulse has been found by following the steps above, hold still and carry out the following steps:
- Use a timepiece or watch with a second hand, or look at a clock with a second hand.
- Over the course of a minute or 30 seconds, count the number of beats felt.
- The number of pulses over a minute is the standard heart rate measurement. This can also be calculated by doubling the number of pulses felt over 30 seconds.
- The pulse should be between 60 and 100 bpm.
The heart should beat steadily, with a regular gap between each contraction, so the pulse should also be steady.
As a general rule, adults will have a resting heart rate of 60 to 100 beats per minute (bpm). In general, people with better physical fitness will have slower heart rates than pepole who exercise less. Athletes, for instance, may have a resting heart rate of just 40 to 60 bpm.
However, it is normal for the heart rate to vary in response to movement, activity, exercise, anxiety, excitement, and fear.
If you feel that your heart is beating out of rhythm or at an unhealthy speed of under 40 bpm or over 120 bpm, and this can be felt when taking a pulse, discuss this with a doctor.
You might also feel that your heart has missed or "skipped" a beat, or there has been an extra beat. An extra beat is called an ectopic beat. Ectopic beats are very common, are usually harmless, and do not need any treatment.
If there are concerns about palpitations or ectopic beats, however, visit a doctor.
Heart rate monitors
Hospitals use monitors that can check the heart rate and the pulse. Heart rate monitors are available for home use and are also available online.
If you use a home monitor, you should:
- check with your doctor that is has been validated
- take your blood pressure at the same time every day
- take several readings and record the results
A clinical development of recent years is the wide range of products now available on the consumer market for personal health monitoring
Cardiac monitors are used in hospital settings to track the vital signs of patients.
Numerous devices can be connected to software apps for mobile phones, and there are a number of health monitoring wearables available that combine the hardware and software in one device.
The United State (U.S.) Food and Drug Administration (FDA) has a page listing a number of the apps cleared by the health product regulator. This might be a good place to start.
Devices are now available that connect to software apps for mobile phones. Some devices for home use include both hardware and software. Some provide readings equivalent to those of an electrocardiogram (ECG) machine.
It is easy to measure a pulse and it can give a useful indication of your state of health.
If you have any concerns regarding your heart rate, speak to a doctor.