Nursing the dorsalis pedis and posterior tibial pulse points

Nursing the dorsalis pedis and posterior tibial pulse points

Femoral pulse

To check the femoral pulse, place the patient flat on their back, ensuring that they are relaxed and comfortable. The femoral pulse is found at the intersection of the thigh and lower abdomen, also known as the inguinal crease, which is roughly halfway between the anterior superior iliac spine and the symphysis pubis. Using this anatomical landmark aids in precisely finding the pulse point.

Place the fingertips of both hands, one on top of the other, on the designated location.  Applying soft but firm pressure might help you feel the pulsation, especially in obese people where the pulse may be deeper and more difficult to detect.  To reduce discomfort for the patient, keep your hands warm, and avoid pushing too hard, as this can obliterate the pulse.

After palpating the femoral artery pulse, count the beats for a full minute to precisely calculate the pulse rate.  Examine the rhythm and strength of the pulse, noting whether it is regular, irregular, strong, or weak.  Comparing the femoral pulse to other peripheral pulses, such as the radial or dorsalis pedis, might reveal valuable information regarding circulatory function and arterial blood flow.

Popliteal Pulse:

To check the popliteal pulse, place the patient with the knee slightly flexed and the leg relaxed, allowing the muscles behind the knee to relax.  Using both hands' fingers, press deeply into the popliteal region, slightly lateral to the midline.  Because the popliteal artery is deep inside the tissues, hard pressure is frequently required to feel the pulsation.

If the popliteal pulse is not perceptible in this position, place the patient on their abdomen and bend the leg roughly 45 degrees at the knee.  This position allows the muscles to relax further and makes the pulse easier to detect.  Once the pulse has been identified, count the beats for one minute and examine the rhythm, strength, and symmetry to determine the lower limb's circulatory health.

Posterior Tibial Pulse:

To check the posterior tibial pulse, palpate along the inner aspect of the ankle, immediately beyond the medial malleolus (the bony prominence on the inside side of the ankle), in the groove between the malleolus and the Achilles tendon.  Apply soft but strong pressure with the fingertips of your index and middle fingers until you feel pulsation.

If the pulse is difficult to find, gently dorsiflex (bend) the foot upward to relax the surrounding tissues and make the pulse more visible.  Once the posterior tibial pulse has been found, count the beats for one minute to precisely calculate the pulse rate.  Examine the rhythm and amplitude of the pulse, since any irregularity or weakness may suggest poor circulation to the lower limbs.

Dorsalis Pedis Pulse:

To find the dorsalis pedis pulse, palpate the top of the foot (dorsum), just lateral to the big toe's extensor tendon.  Use the fingertips of your index and middle fingers to apply extremely light pressure, as excessive power might easily obliterate this pulse due to its superficial placement.

Once you've found the dorsalis pedis pulse, count the beats for a full minute to get an exact pulse rate.  When comparing both feet, look at the rhythm, strength, and equality as well as the rate.  Finally, document the technique by noting the presence, rate, rhythm, and intensity of the pulse, as well as any anomalies or difficulties palpating.