Pulses Lower Extremity
How to Find the Popliteal Pulse
The popliteal pulse, located at the back of the knee (popliteal artery), is the most challenging pulse to find in the body. It’s an important vital sign, though, since the popliteal pulse can help in determining the severity and nature of a knee or femur injury. If you can’t feel the pulse, this doesn’t necessarily mean anything is wrong. The person may just have deep vessels or thick muscles preventing you from feeling the rhythm in the artery. It’s also very unlikely that you’ll be able to feel your own popliteal pulse, so if you are looking to check your own, have a friend help you out.
Locating the Popliteal Artery
Get the patient to lie flat.The popliteal pulse can be more difficult to detect than other pulses, so you want to make sure you have good access to the area. Start by having the patient lie down flat on their back if possible.
- If it is not possible for them to get on their back, have them lie down on their side.
- Relaxation is critical to detecting the popliteal pulse. Let the patient know they should allow the leg to go limp. If they are struggling, it may help to take them through some guided breathing.
Flex the knee.Once the patient is lying down, help them flex their knee to a forty-five degree angle by lifting their leg up by the sides of the knee.
Feel for the artery.Place one hand under the knee for support, and curl your fingers under the knee with the other hand. Use the fingertips to feel for the artery. The artery may feel firmer than the surrounding area, and will provide some resistance when pressed.
- Try not to press too hard, as this could cause discomfort for the other person.
Taking the Pulse
Compress against the artery.Use the tips of your index and middle fingers to compress against the artery. Push slowly and softly, feeling for the pulse. Do not push too hard, as this could cause you to lose the feeling of the pulse. Push just until you feel the beat in the artery.
- Try not to use your thumb as you look for the pulse, as your thumb has its own pulse that may obstruct the reading.
Feel for the pulse rate.The pulse rate is the number of beats per minute you feel while taking the pulse. You can either count for a full 60 seconds to get the pulse rate, or count for 30 seconds and double the number of beats for a solid estimate.
- For an adult, a resting pulse of between 60 and 100 beats per minute is considered within a normal range. If the person was active or under stress immediately before or during the reading, the pulse may be higher.
- Too high or too low a pulse rate could indicate a critical problem. Seek medical help immediately if a pulse is unexpectedly outside of the normal range.
Pay attention to the rhythm.A healthy pulse should have a steady “lub-dub” rhythm. If you are unfamiliar with what this feels like, check your own pulse on your neck or wrist as an indicator. The popliteal pulse should have the same rhythm. If the rhythm is off, seek immediate medical attention.
Checking for Other Complications
Check the dorsalis pedis (DP) pulse.The DP pulse can be used to check for some of the same complications as the popliteal pulse. If you cannot feel the popliteal pulse, look for a pulse in the blood vessels running down the center of the foot. Feel for a pulse as you would with any other vessel.
- Place your index and middle finger over the center of the patient's foot.
Look for signs of infection or disease.Look at the patient’s legs and check for signs of complications such as ulcers, varicose veins, changes in color or pallor, and blackening or missing toes at the extremities. Also, feel for warmth or coolness in the foot. Feeling hot can indicate a problem like an infection, while feeling cold can indicate an occlusion. These signs could be an indicator of critical medical problems that need immediate attention.
Feel the firmness of the artery.When taking the pulse, the popliteal artery may feel more firm than the area surrounding it, but it shouldn’t be hard. If the artery is hard or overly firm, let a doctor know immediately.
- The popliteal pulse is one of the most difficult pulses in the body to detect. It may be impossible to find in very muscular or very overweight individuals. It may also be difficult to detect for those with no medical training. Look for the dorsalis pedis pulse if you cannot find the popliteal pulse.
Video: Pulses of the Lower Limb
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