Pulse
Heart rate; Heart beat
The pulse is the number of heartbeats per minute.
The carotid arteries take oxygenated blood from the heart to the brain. The pulse from the carotids may be felt on either side of thefront of the neck just below the angle of the jaw. This rhythmic beat is caused by varying volumes of blood being pushed out of the heart toward the extremities.
To measure the pulse on the neck, place the index and middle finger just to the side of the Adam's apple, in the soft hollow area. This pulse is felt in the common carotid artery.
How to take your pulse. 1. Place the tips of your index and middle finger on the inside of your wrist below the base of your thumb. 2. Press lightly. You will feel the blood pulsing beneath your fingers. 3. Use a watch or clock with a second hand. Count the beats you feel for 1 minute. Or count the beats for 30 seconds and multiply by 2. This is also called your pulse rate.
Arteries carry oxygenated blood away from the heart to the tissues of the body. Veins carry blood depleted of oxygen from the same tissues back to the heart. The arteries are the vessels with the pulse, a rhythmic pushing of the blood in the heart followed by a refilling of the heart chamber. To determine heart rate, one counts the beats at a pulse point like the inside of the wrist for 10 seconds, and multiplies this number by 6. This is the per-minute total.
How the Test is Performed
The pulse can be measured at areas where an artery passes close to the skin. These areas include the:
- Back of the knees
- Groin
- Neck
- Temple
- Top or inner side of the foot
- Wrist
To measure the pulse at your wrist, place your index and middle finger over the underside of your opposite wrist, below the base of the thumb. Press with flat fingers until you feel the pulse.
To measure the pulse on the neck, place the index and middle fingers just to the side of the Adam's apple, in the soft, hollow area. Press gently until you locate the pulse.
Note: Sit or lie down before taking the neck pulse. The neck arteries in some people are sensitive to pressure. Fainting or slowing of the heartbeat can result. Also, do not take the pulses on both sides of the neck at the same time. Doing so can slow the flow of blood to the head and lead to fainting.
Once you find the pulse, count the beats for 1 full minute. Or, count the beats for 30 seconds and multiply by 2. This will give the beats per minute. It is usually accurate to count the beats for shorter times such as 10 or 15 seconds and then multiply by 6 or 4 respectively. It is usually accurate to count the beats for shorter times, such as 10 or 15 seconds, and then multiply by 6 or 4 respectively.
How to Prepare for the Test
To determine the resting heart rate, you must have been resting for at least 10 minutes. Take the exercise heart rate while you are exercising.
How the Test will Feel
There is a slight pressure from the fingers.
Why the Test is Performed
Measuring the pulse gives important information about your health. Any change from your normal heart rate can indicate a health problem. Fast pulse may signal an infection or dehydration. In emergency situations, the pulse rate can help determine if the person's heart is pumping.
Pulse measurement has other uses as well. During or immediately after exercise, the pulse rate gives information about your fitness level and health.
Normal Results
For resting heart rate:
- Newborns 0 to 1 month old: 70 to 190 beats per minute
- Infants 1 to 11 months old: 80 to 160 beats per minute
- Children 1 to 2 years old: 80 to 130 beats per minute
- Children 3 to 4 years old: 80 to 120 beats per minute
- Children 5 to 6 years old: 75 to 115 beats per minute
- Children 7 to 9 years old: 70 to 110 beats per minute
- Children 10 years and older, and adults (including seniors): 60 to 100 beats per minute
- Well-trained athletes: 40 to 60 beats per minute
What Abnormal Results Mean
Resting heart rates that are continually high (tachycardia) may mean a problem. Talk to your health care provider about this. Also discuss resting heart rates that are below the normal values (bradycardia).
A pulse that is very firm (bounding pulse) and that lasts for more than a few minutes should be checked by your provider as well. An irregular pulse can also indicate a problem.
A pulse that is hard to locate may mean blockages in the artery. These blockages are common in people with diabetes or hardening of the artery from high cholesterol. Your provider may order a test known as a Doppler study to check the blockages.
References
Bernstein D. History and physical examination in cardiac evaluation. In: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 449.
Schriger DL. Approach to the patient with abnormal vital signs. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 7.
Version Info
Last reviewed on: 2/2/2023
Reviewed by: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
