How to Take an Apical Pulse

Step-by-Step Guide

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   Step 1: Start by asking the patient to take off their shirt.

   To take the apical pulse, you will need to access the bare chest. , Feel for the clavicle.
   
   The clavicle is also called the collarbone.
   
   It can be felt at the top of the rib cage.
   
   Directly below the clavicle, you should feel the first rib.
   
   The space between two ribs is called the intercostal space.Feel for the first intercostal space—the space between the first and second ribs. , From the first intercostal space, move your fingers down to the fifth intercostal space by counting the ribs.
   
   The fifth intercostal space should be located between the fifth and sixth ribs. , This is called the midclavicular line.
   
   The apical pulse can be felt and heard at the intersection of the fifth intercostal space and the midclavicular line., The apical pulse can be taken by touch or by using a stethoscope.
   
   It can be very difficult to feel an apical pulse, especially in women where breast tissue may lie over the pulse.
   
   A stethoscope may be easier for this purpose. , Take your stethoscope from your neck and direct the earpiece outward towards the person.
   
   Put the earpiece on your ears and hold the diaphragm (the part of the stethoscope that you place over the person’s heartbeat).
   
   Rub the diaphragm a bit to warm it up and tap it to make sure that you can hear the noises through the diaphragm. , Tell the person to breathe normally through his or her nose because doing so will decrease the sound of the breath and make hearing the heart easier.
   
   You should hear two sounds: lub-dub.
   
   This is considered one beat. , This is the pulse rate, or heart rate.
   
   Think about how you might describe the pulse.
   
   Is it loud? Forceful? Is the rhythm regular, or does it seem random? , Be ready with a watch that has a second hand so you can count the pulse rate.
   
   Count how many “lub-dubs” you hear in a minute (60 seconds).
   
   The normal pulse rate for adults is 60 – 100 beats per minute.
   
   It differs with children.With newborns to three years old, the normal heart rate is 80-140.
   
   For four to nine year olds, 75-120 is a normal heart rate.
   
   For 10 to 15 years old, 50-90 beats per minute is the normal pulse rate.
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   Step 2: Feel the first rib by finding the clavicle.

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   Step 3: Count the ribs as your work your way down.

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   Step 4: Draw an imaginary line that runs from the middle of the clavicle on the left side through the nipple.

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   Step 5: Decide between using regular touch or a stethoscope.

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   Step 6: Prepare your stethoscope.

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   Step 7: Place the stethoscope on the spot where you found the apical pulse.

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   Step 8: Count how many lub-dub sets you hear in one minute.

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   Step 9: Find the person’s heart rate.

Detailed Guide

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