combat life saver lesson 18 measure and monitor a casualty's pulse compiled and edited by, 2lt...

Combat Life SaverCombat Life Saver

Lesson 18Lesson 18MEASURE AND MONITOR AMEASURE AND MONITOR A

CASUALTY'S PULSECASUALTY'S PULSE

Compiled and edited by,2LT John C. Miller, PA-C

Lesson 18Lesson 18MEASURE AND MONITOR AMEASURE AND MONITOR A

CASUALTY'S PULSECASUALTY'S PULSE

INTRODUCTIONINTRODUCTION

When you evaluate a casualty, you may need to take When you evaluate a casualty, you may need to take his pulse. Taking the casualty's pulse is an important his pulse. Taking the casualty's pulse is an important step in identifying hypovolemic shock and in step in identifying hypovolemic shock and in determining if additional antidote is to be determining if additional antidote is to be administered to nerve agent casualties. In this administered to nerve agent casualties. In this lesson, you will learn to determine the number of lesson, you will learn to determine the number of pulse beats per minute and identify if the casualty's pulse beats per minute and identify if the casualty's pulse rate, strength, and rhythm are normal or pulse rate, strength, and rhythm are normal or abnormal. By evaluating the casualty's pulse, you are abnormal. By evaluating the casualty's pulse, you are really evaluating the effectiveness of the casualty's really evaluating the effectiveness of the casualty's heart action.heart action.

MEASURE AND MONITOR AMEASURE AND MONITOR ACASUALTY'S PULSECASUALTY'S PULSE

TASKTASK

Determine a casualty's pulse rate and describe the Determine a casualty's pulse rate and describe the characteristics of the pulse.characteristics of the pulse.

CONDITIONSCONDITIONS

Given a simulated casualty and a timepiece with a Given a simulated casualty and a timepiece with a second hand.second hand.

STANDARDSSTANDARDS

Score a GO on the performance checklist.Score a GO on the performance checklist.

LOCATE THE PULSE SITELOCATE THE PULSE SITE

When the heart pumps and forces blood into the When the heart pumps and forces blood into the arteries, the surge of blood creates a wave-like effect arteries, the surge of blood creates a wave-like effect which can be felt by pressing gently on an artery. which can be felt by pressing gently on an artery. This effect is called This effect is called the pulsethe pulse. It is usually easier to . It is usually easier to feel the pulse if the artery is on top of a bony area feel the pulse if the artery is on top of a bony area such as the wrist or ankle or if the artery can be such as the wrist or ankle or if the artery can be pressed against a fairly rigid structure such as the pressed against a fairly rigid structure such as the trachea in the neck.trachea in the neck.


Carotid PulseCarotid Pulse A common location for taking the pulse is the neck. A common location for taking the pulse is the neck.

There are two large arteries near the front of the There are two large arteries near the front of the throat which supply the head with blood. These throat which supply the head with blood. These arteries are called the carotid arteries.arteries are called the carotid arteries.

One artery is located in a groove on the right side of One artery is located in a groove on the right side of the larynx and the other artery is located in a groove the larynx and the other artery is located in a groove on the left side of the larynx. The artery on the on the left side of the larynx. The artery on the casualty's left side is the left carotid artery and the casualty's left side is the left carotid artery and the artery on the casualty's right side is the right carotid artery on the casualty's right side is the right carotid artery. Either artery can be used to take the artery. Either artery can be used to take the casualty's carotid pulse.casualty's carotid pulse.


To locate the artery, place the middle and index To locate the artery, place the middle and index fingers on the casualty's larynx, which is usually fingers on the casualty's larynx, which is usually called the Adam's apple.called the Adam's apple.

Move the fingers to the side until you feel the groove Move the fingers to the side until you feel the groove created by the muscles next to the trachea.created by the muscles next to the trachea.

Press on the groove until you feel the pulse.Press on the groove until you feel the pulse. QuestionQuestion: :

• Why don't you use your thumb when taking a casualty's Why don't you use your thumb when taking a casualty's pulse?pulse?

ResponseResponse: : • The thumb has a pulse of its own. You may be taking your The thumb has a pulse of its own. You may be taking your

pulse instead of the casualty's pulse.pulse instead of the casualty's pulse.


Radial PulseRadial Pulse Another common location for taking the pulse is the Another common location for taking the pulse is the

wrist. When taking the pulse at the wrist, gently press wrist. When taking the pulse at the wrist, gently press the radial artery against the bones of the wrist. The the radial artery against the bones of the wrist. The radial pulse is taken on the inside of the wrist near radial pulse is taken on the inside of the wrist near the base of the thumb. the base of the thumb. Do notDo not use the back of the use the back of the wrist. Either wrist can be used to take the casualty's wrist. Either wrist can be used to take the casualty's radial pulse.radial pulse.


QuestionQuestion: : • When would you need to take a casualty's radial pulse?When would you need to take a casualty's radial pulse?

ResponseResponse: : • You have applied a splint to a fractured arm and want to You have applied a splint to a fractured arm and want to

check the casualty's blood circulation below the splint.check the casualty's blood circulation below the splint.


Posterior Tibial PulsePosterior Tibial Pulse A less common location for taking the pulse is the A less common location for taking the pulse is the

ankle. When taking the pulse at the ankle, gently ankle. When taking the pulse at the ankle, gently press the posterior tibial artery against the bones of press the posterior tibial artery against the bones of the ankle. The pulse is taken on the inside of the the ankle. The pulse is taken on the inside of the ankle behind the large ankle bone. The pulse can be ankle behind the large ankle bone. The pulse can be found using either ankle.found using either ankle.


QuestionQuestion: : • When would you need to take a casualty's posterior tibial When would you need to take a casualty's posterior tibial

pulse?pulse?

ResponseResponse: : • You have applied a splint to a fractured leg and want to You have applied a splint to a fractured leg and want to

check the casualty's blood circulation below the splint.check the casualty's blood circulation below the splint.


Other Pulse SitesOther Pulse Sites The The temporal pulsetemporal pulse is felt at the temple near the ear. is felt at the temple near the ear. The The brachial pulsebrachial pulse is felt on the inside of the elbow. is felt on the inside of the elbow. The The femoral pulsefemoral pulse is felt in the groin area. is felt in the groin area. The The popliteapopliteal pulse is felt behind the knee.l pulse is felt behind the knee. The The dorsalis pedisdorsalis pedis pulse is felt on top of the foot. pulse is felt on top of the foot. A pulse may also be felt directly over the heart on the A pulse may also be felt directly over the heart on the

left side of the casualty's chest. This pulse is called left side of the casualty's chest. This pulse is called the the apical pulseapical pulse..

TAKE THE CASUALTY'S PULSETAKE THE CASUALTY'S PULSE

Changes in the casualty's pulse rate and in the Changes in the casualty's pulse rate and in the strength of the pulse beats indicate changes in the strength of the pulse beats indicate changes in the beating of the casualty's heart.beating of the casualty's heart.

Palpate the Pulse SitePalpate the Pulse Site Place the tips of your index and middle fingers over Place the tips of your index and middle fingers over

the pulse site and press gently.the pulse site and press gently. Count the Pulse Beats for One MinuteCount the Pulse Beats for One Minute Using a clock with a second hand, count the pulse for Using a clock with a second hand, count the pulse for

one full minute.one full minute.


A A normalnormal pulse rate for an adult when resting is pulse rate for an adult when resting is between 60 to 80 beats per minute. The average is between 60 to 80 beats per minute. The average is 72 beats per minute.72 beats per minute.

A resting pulse rate of more than 80 beats per minute A resting pulse rate of more than 80 beats per minute is a higher than normal pulse rate. This can be is a higher than normal pulse rate. This can be caused by shock, bleeding, heat, dehydration, fever, caused by shock, bleeding, heat, dehydration, fever, pain, emotions, and vigorous activity (such as pain, emotions, and vigorous activity (such as running).running).


TachycardiaTachycardia is an abnormal condition that exists is an abnormal condition that exists when the casualty's pulse rate is over 100 beats per when the casualty's pulse rate is over 100 beats per minute.minute.

A resting pulse rate of less than 60 beats per minute A resting pulse rate of less than 60 beats per minute is a lower than normal pulse rate which can be is a lower than normal pulse rate which can be caused by heart disease and medications.caused by heart disease and medications.

A pulse rate below 60 may also occur in a soldier A pulse rate below 60 may also occur in a soldier who is physically fit.who is physically fit.

A pulse rate of less than 50 beats per minute is called A pulse rate of less than 50 beats per minute is called bradycardiabradycardia..


Classify the Strength of the PulseClassify the Strength of the Pulse Regular -- Pulse is easy to feel and has even beats of Regular -- Pulse is easy to feel and has even beats of

good force.good force. Bounding -- Pulse is easily detected due to the Bounding -- Pulse is easily detected due to the

exceptionally large amount of blood being pumped exceptionally large amount of blood being pumped with each heartbeat.with each heartbeat.

Weak -- Pulse is difficult to detect due to a decreased Weak -- Pulse is difficult to detect due to a decreased amount of blood flowing through the arteries, usually amount of blood flowing through the arteries, usually due to bleeding or shock.due to bleeding or shock.

Absent -- Pulse cannot be detected, usually due to a Absent -- Pulse cannot be detected, usually due to a blocked or injured artery or due to a lack of heart blocked or injured artery or due to a lack of heart action.action.


QuestionQuestion: : • At which pulse site will you probably feel the most distinct At which pulse site will you probably feel the most distinct

pulse?pulse?

ResponseResponse: : • The carotid pulse site.The carotid pulse site.

MONITOR THE CASUALTY'S PULSEMONITOR THE CASUALTY'S PULSE

If you remain with the casualty for a significant If you remain with the casualty for a significant amount of time, take the casualty's pulse periodically amount of time, take the casualty's pulse periodically and note any significant changes in rate, rhythm, or and note any significant changes in rate, rhythm, or strength of the casualty's pulse. Remember that an strength of the casualty's pulse. Remember that an irregular or fluctuating pulse may indicate an early irregular or fluctuating pulse may indicate an early stage of hypovolemic shock and a weak and rapid stage of hypovolemic shock and a weak and rapid pulse may indicate a more advanced stage of pulse may indicate a more advanced stage of hypovolemic shock.hypovolemic shock.

MEASURE AND MONITOR AMEASURE AND MONITOR ACASUALTY'S PULSECASUALTY'S PULSE

CLOSINGCLOSING

Taking a casualty's pulse is important in identifying Taking a casualty's pulse is important in identifying shock and in evaluating a nerve agent casualty, shock and in evaluating a nerve agent casualty, which we will discuss shortly. In a chemical which we will discuss shortly. In a chemical environment, you will need to count a chemical agent environment, you will need to count a chemical agent casualty's carotid pulse rate while wearing your casualty's carotid pulse rate while wearing your protective gloves.protective gloves.

QuestionsQuestions

combat life saver lesson 18 measure and monitor a casualty's pulse compiled and edited by, 2lt...

Documents