How to do a Pulse Check

The importance of self-screening for Atrial Fibrillation

Atrial fibrillation or AF is an irregular heartbeat and can be a serious condition if not diagnosed, treated and monitored. It occurs when the upper chambers of the heart, known as the atria beat irregularly and often rapidly. 

This can lead to the formation of blood clots which can enter the blood stream and block circulation to the brain, causing a stroke.

Atrial fibrillation may cause a person to have symptoms, such as episodes of shortness of breath, dizziness or light headedness, and/or fatigue or tiredness. Some feel a thumping in the chest, called palpitations.

However, many people have NO symptoms and so, the simple way of detecting AF is by performing a regular pulse check. 

There are other causes for irregular heart rhythm and rate besides AF, so see your doctor or healthcare practitioner if you have symptoms.

A pulse check is simple and easy to do.

Every heartbeat creates a wave of pressure, as blood flows along the arteries. Where these arteries lie closest to the surface, this pressure wave can be felt as a pulse.

Checking your own pulse allows you to determine your heart rate and rhythm with out any special equipment. Once you’ve mastered the technique of checking your pulse, teach your friends and family.

You'll need a clock or watch with second hand/display.

Steps:

1. Check the radial pulse. This is also known as the pulse on the inside of the wrist. Use your right index and middle finger to check the pulse on your left arm. If you are left-handed, use your left index finger and middle finger to check the pulse on your right arm. Use the pads of these fingers and place these just below the wrist creases at the base of the thumb.
   
   
2. Don’t use your thumb if checking someone else’s, as it has its own pulse.
   
   
3. Press the radial artery that you are trying to feel with your index finger.
   
   
4. Feel the pulsation (blood pulsing under your fingers) with your middle finger by gently touching the skin whilst maintaining a firm pressure with your index finger.
   
   
5. If necessary, move fingers around until you feel the pulse.
   
   
6. As soon as you feel the pulsations, look at the clock/watch and start counting the number of pulsations and continue to count for one full minute.
   
   
7. A normal pulse rate is between 60 to 100 beats per minute. Pulse may be increased if you have high temperature or fever. Athletes may have a pulse as low as the 40s, however, that is considered normal.
   
   
8. Besides the number of pulsations, you should also check the rhythm or regularity of the pulse. 
   
   
9. A normal pulse again is strong and regular. Irregular pulse is almost always abnormal and can be due to a number of heart conditions, such as atrial fibrillation or heart block.
   
   
10. If your pulse is irregular or if it is too fast or slow, notify your doctor or healthcare practitioner.

(With thanks to Edward Cajilog our British Heart Foundation arrhythmia specialist nurse at Queen Mary’s Hospital, London.)

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