How to take a radial pulse
You take a radial pulse by feeling the artery on the thumb side of the wrist and counting the beats. The one idea that makes it click: count for a full 60 seconds and record within four beats of the evaluator — no shortcuts, no thumb.
Step-by-step
- 1
Knock, wash your hands, introduce yourself, and identify the resident.
- 2
Explain what you are doing, provide for privacy, and have a watch with a second hand ready.
- 3
Rest the tips of two or three fingers on the thumb side of the resident's inner wrist to find the radial pulse. Never use your thumb — it has its own pulse.Critical
- 4
Once you feel a steady beat, count the pulse for one full 60 seconds.Critical
- 5
Note the rate, and observe whether the rhythm is regular and the beat is strong or weak.
- 6
Make the resident comfortable and place the call signal within reach.
- 7
Wash your hands.
- 8
Record the pulse rate and report anything abnormal to the nurse.Critical
Critical steps (do not miss these)
- Count the full 60 seconds — never count 15 or 30 seconds and multiply.
- Your recorded rate must be within plus or minus 4 beats per minute of the evaluator's reading.
- Palpate with your fingertips on the thumb (radial) side of the wrist, never with your own thumb.
- Wash hands and record before leaving, and leave the signaling device within reach.
Common mistakes
- Counting for a partial period and multiplying, which loses accuracy on an irregular pulse.
- Using the thumb to palpate and accidentally counting your own pulse.
- Forgetting to record, or recording outside the plus/minus 4-beat tolerance.
- Leaving without placing the call light within the resident's reach.
Why it matters
The radial artery lies just under the skin at the wrist, so light fingertip pressure feels each heartbeat. A full minute captures any irregular beats that a 15- or 30-second count would miss, and the plus/minus 4-beat tolerance is the exam's proof that you actually counted rather than estimated.