Learn How to Feel a Pulse and You Could Save a Life
The following is adapted from Dad Lived to 101 and You Can Too.
During anesthesia, physiological monitoring is essential—your operating room experience is much safer because of it. Administering anesthesia without using any monitoring devices or techniques is like driving without headlights during a moonless night, in total darkness: you don’t know where you are, and you don’t know when or which way to turn. Anesthesiologists must have information on what is physiologically happening to your body to carry you safely through an operation.
In the operating room, one of the primary reasons we use an electrocardiogram monitor is to detect arrhythmias. At home, instead of an ECG, you can learn to monitor for an irregular heart rhythm by applying the simple technique of palpating a pulse.
Twice in my life, outside of a medical setting, I detected life-threatening arrhythmias by simply feeling someone’s radial pulse and sensing its rhythm. Sure, it helped that I am an anesthesiologist, but believe me, you can do it too. It just takes practice.
One morning, I saw my mother, Wai, in the kitchen making breakfast. She appeared to be her usual healthy and active eighty-six-year-old self but mentioned to me that she was a bit lightheaded. She wasn’t dizzy, didn’t feel like fainting, and didn’t have any trouble going about her day. She simply noticed there was something different in the way she was feeling. It was hard for Wai to describe her symptoms.
Her complaints were vague and didn’t appear serious. But just to be sure, I reached out, put my fingers on my mother’s wrist, and felt for the radial pulse. It was such an easy maneuver that provided critical information about her condition. In less than a minute, I discovered that the rhythm of her pulse was very irregular. The beats of her pulse occurred randomly—I felt some immediately after another, some after a short pause, and some after a long pause. There was no predictability as to when I would feel the next beat.
This finding was new for Wai. She didn’t have a prior history of an irregular heart rhythm, so I knew right then that this was a medical emergency. Within a couple of hours, she was seen by a cardiologist, who confirmed the diagnosis of atrial fibrillation (AFib) and immediately started on anticoagulant medication to prevent a stroke, one of the most dangerous complications of this arrhythmia.
The other time I uncovered an irregular heart rhythm outside of work was with another senior family member. He was at a family birthday party when he felt very tired—so much so that he had to lie down. When I went to check on him, he complained only of feeling weak. I felt his pulse and, again, within a minute, I recognized that this, too, was a medical emergency. He needed to go immediately to the hospital.
In minutes, we were in the car and on our way. In the emergency room, the electrocardiogram monitor showed AFib with occasional outbreaks of sustained ventricular tachycardia, an even more serious life-threatening arrhythmia. He was treated with intravenous antiarrhythmics and blood thinning drugs, and admitted to the coronary care unit.
It’s important to realize that, in both these cases, neither my mother nor my other relative had any severe complaints. They would not have sought medical care if I hadn’t bothered to feel their pulse—a simple, convenient, and quick monitoring technique. Left undiscovered, the irregular heart rhythms could have led to a stroke or a sudden cardiac event, including cardiac arrest and death.
How to Feel for the Radial Pulse
A pulse is a palpable wave of blood that is generated by the contraction of the heart. This pulse wave travels throughout the arteries of the body and can be best felt at the wrist, neck, and groin. Each pulse you detect represents a heartbeat. The number of pulses you feel per minute normally corresponds to your heart rate.
The pulse of the radial artery can be felt on the thumb side of your wrist. Using a moderate amount of pressure, place your index and middle fingers along the wrist creases, below your thumb. You may sense the pulse right away. If you don’t, slowly slide your fingertips sideways, in tiny increments, along the creases. You may notice two prominent cord-like structures (tendons) in the middle of your wrist. Always stay to the thumb side of these tendons. Vary your finger pressure to learn what amount of force is best for your digits to detect the wave of blood. If you practice enough, it should take only a minute or less (usually seconds) to find the radial pulse in most individuals.
When you feel the pulse, note its rhythm. It may be fast or slow, but it should be regular and steady. You can tap out or sound out the beats of the pulse and predict when the next beat will occur. Try it. You can have an occasional extra or skipped beat, but overall the beats should be occurring regularly. With an irregular rhythm, there is no predictability or pattern to the pulse. The beats seem to occur haphazardly. If you detect an irregular pulse, seek medical attention. It could prevent a stroke or save the life of you or a loved one.
Note: There are now smart devices, including smartwatches, that can produce a simplified electrocardiogram reading to help detect AFib and other abnormal heart rhythms. They should be considered a potentially important part of your physiological monitoring tools.
For more advice on how to be proactive with your health, you can find Dad Lived to 101 and You Can Too on Amazon.
Dr. Bill Tsu became a health and fitness enthusiast when he was a young teen playing the role of English translator for his immigrant parents during their doctor visits. This experience sparked his passion for learning about the human body and what it takes to stay healthy. Now, with a career in medicine that spans more than thirty years, a degree in engineering, and a lifetime of caring for a centenarian, Dr. Tsu has written this unique book that will help others improve their health and live longer.