What would be the best action would the nurse do if unable to palpate the right radial pulse on a patient?

5 tips to quickly find a patient's radial pulse for vital sign assessment

I had a college professor whom, when he rested his hands behind his head, I could watch the radial arteries on his hands pulsate.

For most patients, finding the patient's radial pulse is fairly easy. Print a copy of these tips for your pocket.

If you are having trouble finding a conscious patient’s radial pulse, try these five tips:

1. Move long sleeve clothing, gloves, mittens watches or jewelry out of the way. It is important to palpate (to feel) the patient's bare skin. 
2. Cock or extend the patient’s wrist to bring their radial artery closer to the surface.
3. Palpate the distal end of the radius; then slowly draw two or three of your fingers towards the radial artery. Move your fingers proximally as you lightly scan to locate the patient's radial artery. If that doesn't work try to;
4. Palpate the base of the patient’s thumb; then draw two or three fingers proximally towards the radial artery.
5. If you are still having trouble, use a pulse oximeter or auscultate the patient's heart to get a feel for the rhythm and rate of heartbeat you are attempting to palpate. 

If you are unable to find the radial pulse on one wrist, switch to the patient’s other wrist. Once you have found a difficult to find radial pulse, consider using a ballpoint or felt pen to make a light mark at the pulse location in order to make reassessment easier.

What else works well for finding a radial pulse? Why might a radial pulse be absent or diminished?

Share your radial pulse and vital sign assessment tips in the comments area. Also check out these tips to find a patient's pedal pulse.

This article, originally published April 9, 2009, has been updated

Greg Friese, MS, NRP, is the Lexipol Editorial Director, leading the efforts of the editorial team on Police1, FireRescue1, Corrections1 and EMS1. Greg served as the EMS1 editor-in-chief for five years. He has a bachelor's degree from the University of Wisconsin-Madison and a master's degree from the University of Idaho. He is an educator, author, national registry paramedic since 2005, and a long-distance runner. Greg was a 2010 recipient of the EMS 10 Award for innovation. He is also a three-time Jesse H. Neal award winner, the most prestigious award in specialized journalism, and the 2018 and 2020 Eddie Award winner for best Column/Blog. Connect with Greg on Twitter or LinkedIn and submit an article idea or ask questions with this form.