Pulse readings on infants

[Gents82]

Okay, I still haven't worked a day in the field yet, but every now and then whenever I encounter an infant I'll try and see if I can get a pulse by palpation and I find it extremely difficult. And I palpate the areas the book says, carotid and brachial artery. Between all the loose baby fat and their hurky jerky movements I just cant feel anything, unless I take a stethoscope directly over the heart. Is this looked down upon? Or do they want you to make sure its circulating correctly throughout the body.

[Ridryder911]

You should always get an apical pulse rate (heart rate per stethoscope) on all infants <1 year old. It is too dificult to obtain radial etc.. This can be done easily by listneing posterior for the 10 or 15 second method if the pulse rate is regular. One needs to be sure to document such as that ..i.e. 130 apical....

Checking the palm (like you do for capillary refill) and temp. for adequate circulation.

R/R 911

[JJR512]

When you listen to the heart, it's two beats that you hear equals one pulse, correct? I mean... each thud-thud...thud-thud...thud-thud...thud-thud... Each pair of "thud-thuds" is one pulse, correct?

[ffemt8978]

I agree with Rid on this one, but I'd be real leary of attempting a carotid pulse on an infant.

[SWVAEMT]

..................I'd be real leary of attempting a carotid pulse on an infant.

I believe checking corotid pulse on an infant is contraindicated, is it not?

[Ridryder911]

Lub-Dub = 1 pulse.....Usually it is so fast you can only hear one tone..

R/R 911

[Gents82]

I believe checking corotid pulse on an infant is contraindicated, is it not?

now that I think about it I believe the second option for infants is femoral, not carotid... does that sound better? still hard to palpate through all that leg fat.

[DT4EMS]

I listen apical and palpate the brachial at the same time. This way I can feel for the pulse as I listen. It helps me anyway.

Like Rid said, in infants check for sign of perfusion like activity, cap refill, color and temp in small infants. That is really a great guage of B/P in infants.

No matter what it will still take practice to get comfortable with an infant. Don't stress too hard. Everyone was new at it sometime.

Kip