For 10 to 15 years old, 50-90 beats per minute is the normal pulse rate.For four to nine year olds, 75-120 is a normal heart rate.With newborns to three years old, the normal heart rate is 80-140.The normal pulse rate for adults is 60 вЂ“ 100 beats per minute. Count how many вЂњlub-dubsвЂќ you hear in a minute (60 seconds). Be ready with a watch that has a second hand so you can count the pulse rate. Is it loud? Forceful? Is the rhythm regular, or does it seem random? Think about how you might describe the pulse. Count how many lub-dub sets you hear in one minute.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. Place the stethoscope on the spot where you found the apical pulse.

Rub the diaphragm a bit to warm it up and tap it to make sure that you can hear the noises through the diaphragm.

Put the earpiece on your ears and hold the diaphragm (the part of the stethoscope that you place over the personвЂ™s heartbeat). Take your stethoscope from your neck and direct the earpiece outward towards the person. A stethoscope may be easier for this purpose. It can be very difficult to feel an apical pulse, especially in women where breast tissue may lie over the pulse. The apical pulse can be taken by touch or by using a stethoscope.

Decide between using regular touch or a stethoscope.

The apical pulse can be felt and heard at the intersection of the fifth intercostal space and the midclavicular line.

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

The fifth intercostal space should be located between the fifth and sixth ribs.

From the first intercostal space, move your fingers down to the fifth intercostal space by counting the ribs. Count the ribs as your work your way down.Feel for the first intercostal space-the space between the first and second ribs.The space between two ribs is called the intercostal space. Directly below the clavicle, you should feel the first rib. It can be felt at the top of the rib cage. The clavicle is also called the collarbone. Feel the first rib by finding the clavicle.To take the apical pulse, you will need to access the bare chest. Start by asking the patient to take off their shirt.In contrast to other pulses, the apical pulse is measured over the heart and not an artery and is commonly heard with a stethoscope as opposed to palpated. Temporal pulse - The temporal pulse (i.e., superficial temporal artery) is palpated on the temple directly in front of the ear with the index finger.ДЄpical pulse - The unilateral apical pulse (i.e., apex of the heart) can be located in the fifth intercostal space immediately to the left of the sternum using a stethoscope. Posterior tibial pulse - The posterior tibial pulse is palpated posterior and inferior to the medial malleolus by gently pressing the tibial artery against the underlying bone with the middle and index fingers.Дorsalis pedis pulse - The dorsalis pedis pulse is palpated in the groove between the first and second toes slightly medial on the dorsum of the foot (i.e., dorsal-lateral to the extensor hallucis longus tendon and distal to the dorsal prominence of the navicular bone) with the middle and/or index fingers. Popliteal pulse - The popliteal pulse is palpated on the posterior knee with the middle and index fingers this pulse is more difficult to palpate as compared to other pulse sites. Radial artery pulse - The radial pulse is palpated immediately above the wrist joint near the base of the thumb (i.e., common site), or in the anatomical snuff box (i.e., alternative site), by gently pressing the radial artery against the underlying bone with the middle and index fingers.ДЇemoral pulse - The femoral pulse is palpated over the ventral thigh between the pubic symphysis and anterior superior iliac spine with the middle and index fingers. The brachial artery pulse is commonly used to measure blood pressure with a stethoscope and sphygmomanometer. Carotid artery pulse - The common carotid artery is palpated on the neck below the jaw and lateral to the larynx/trachea (i.e., mid-point between your earlobe and chin) using the middle and index fingers.Д«rachial artery pulse - The brachial artery is palpated on the anterior aspect of the elbow by gently pressing the artery against the underlying bone with the middle and index fingers.

Apical pulse location