How Do You Check the Brachial Artery Pulse Correctly?

The brachial artery pulse is used as a diagnostic tool in healthcare, particularly for checking circulation in infants and measuring blood pressure in adults. Located in the upper arm, this pulse point offers direct access to arterial blood flow. This location makes it an essential reference for both medical professionals and those learning first aid. 

According to some medical studies, the brachial pulse is one of the most commonly used pulse points in neonatal care, where accurately assessing circulation can make a life-saving difference. 

Correct checking of the brachial artery pulse also ensures the proper monitoring of cardiovascular health and aids in the precise measurement of blood pressure, which is vital for preventing and managing conditions like hypertension.

What is Brachial Artery?

The brachial artery is the main blood vessel supplying oxygen-rich blood to the arm, elbow, and hand. It originates from the axillary artery and runs along the front part of the bicep. It is close to the humorous bone and is thus used in several clinical examinations, such as pulse and blood pressure measurements. The brachial artery also serves as an important indicator of heart function and overall circulatory health.

What is the Brachial Artery?

The brachial artery originates from the axillary artery, which travels through the shoulder and upper arm. As the axillary artery transitions past the lower border of the teres major muscle, it becomes the brachial artery. This vessel runs along the upper arm, eventually splitting into two main branches—the radial and ulnar arteries—just below the elbow. 

The radial artery is often used to check the pulse at the wrist, while the brachial artery pulse is most accessible in the upper arm.

Location of the Brachial Pulse

Before learning how to check the brachial artery pulse, it’s essential to know where it is located. The brachial pulse is typically felt in the upper arm, along the inside (medial side) of the arm, between the biceps and triceps muscles.

Brachial Pulse Location in Adults

In adults, the brachial artery pulse is most easily located at the antecubital fossa, the bend of the elbow on the inner arm. The lay responder can follow these steps to identify the brachial pulse location: 

1. Position the Arm: Have the person extend their arm slightly and turn the palm upward.
2. Feel for the Pulse: Place the tips of your index and middle fingers just above the elbow crease on the inside of the arm. Apply gentle pressure to feel the pulsation of the brachial artery.

Since the brachial artery runs along the arm’s medial side, it may take a bit of practice to find the exact spot. However, with light pressure, the artery’s rhythmic pulse should become detectable.

Brachial Pulse Location in Infants

In infants, the brachial pulse is located higher up the arm, typically near the middle of the upper arm. Infants have smaller limbs, which makes it a bit challenging to locate their pulse, but it is still accessible. To find the pulse in an infant:

1. Extend the Arm: Hold the infant’s arm slightly extended and use your fingers to feel along the upper arm, close to the inner side.
2. Press Lightly: Use gentle pressure, as the pulse may be weaker than that of an adult. The pulse will typically be felt between the biceps and triceps muscles.

Since the brachial artery is more pronounced in infants, this is a preferred site for checking the pulse in newborns and young children, especially in medical settings like neonatal intensive care units (NICUs).

How to Check the Brachial Artery Pulse Correctly

Now that we know the location of the brachial artery pulse let’s look at the correct steps for checking it in adults and infants. While the basic technique is similar across different age groups, there are some nuances in how pressure is applied and how the pulse is interpreted.

1. Preparation and Positioning

Proper arm positioning is important in locating the brachial artery pulse. Whether you are checking your pulse or that of someone else, follow these preparatory steps to ensure accuracy: 

• Positioning for Adults

To properly check the brachial artery pulse in adults, have the person extend their arm slightly with the palm facing upward. This position opens up the antecubital fossa, making it easier to detect the pulse. The layperson should also ensure that the person is seated or lying comfortably, as stress or discomfort can affect both blood pressure and pulse accuracy.

• Positioning for Infants

Proper positioning is crucial for infants. Gently secure the infant’s arm, keeping it straight but not fully extended. When searching for the pulse, use a gentle touch, as infants have delicate skin and tissues. Always prioritize comfort and care to ensure accurate readings.

2. Locating the Brachial Artery Pulsation

Once the arm is properly positioned, the next step is to locate the pulse by gently pressing on the brachial artery. Here’s how to do it correctly:

• For Adults

Place the pads of your index and middle fingers just above the elbow crease on the inner side of the arm. Avoid using your thumb, as its pulse can interfere with an accurate reading. Apply light pressure until you feel the rhythmic pulse of the artery. It may take a few seconds to detect the pulse, especially in individuals with low blood pressure, so patience is key.

• For Infants

Gently press your index and middle fingers along the middle of the upper arm. Infant pulses are typically lighter and faster than those of adults, so use soft pressure to avoid missing the subtle pulsations.

3. Interpreting the Pulse

Once the pulse is found, it’s important to assess its characteristics, as they can provide insights into cardiovascular health. First check pulse rate:  

• Adults: A normal resting pulse rate for an adult is between 60 and 100 beats per minute. If you count the pulse for 15 seconds and multiply the number by four, you can estimate the heart rate.
• Infants: An infant’s resting heart rate is much higher, typically between 120 and 160 beats per minute. You can use the same method (count for 15 seconds and multiply by four) to determine their heart rate.

Factors Affecting Brachial Pulse Readings

Several factors can influence the accuracy of the brachial pulse reading. These must be considered for a precise evaluation.

• Age and Pulse Rate Differences

Normal heart rate for adults ranges between 60 and 100 bpm. However, for children, the heart rate typically falls between 70 and 120 bpm. The heart rate in infants is much higher, ranging from 100 to 160 bpm.

• Medical Conditions Impacting Pulse

Careful monitoring of the pulse can detect conditions like tachycardia (rapid heart rate) or bradycardia (slow heart rate).

• Tachycardia can result from stress, dehydration, or infection.
• Bradycardia might be a sign of heart issues or can occur naturally in well-trained athletes.

Why is the Brachial Pulse Important?

Checking the brachial artery pulse is essential in many clinical settings, especially when it comes to monitoring blood pressure and circulation. Let’s explore some of the most common uses and reasons why this pulse point is significant.

1. Blood Pressure Measurement

The brachial pulse is central to measuring blood pressure. During a blood pressure test, a cuff is placed around the upper arm, and the brachial artery pulse is monitored to determine systolic and diastolic pressures. Here’s how it works:

• Cuff Inflation: The cuff is inflated until blood flow through the brachial artery is temporarily stopped.
• Pulse Monitoring: As the cuff deflates, the first pulsations heard through a stethoscope indicate the systolic pressure, and the last audible pulse represents the diastolic pressure.

2. Neonatal Care

In infants, the brachial pulse is often the preferred location to check pulse and assess circulation. This is because radial or carotid pulses in newborns are difficult to locate and result in false assessments. 

When an infant meets an emergency, rescuers can check for a pulse by placing 2 or 3 fingers on the inside of the upper arm between the shoulder and elbow. They will have to press the fingers down gently for 5 to 10 seconds to get a pulse.

3. Assessing Circulatory Health

Regularly checking the brachial artery pulse can help assess circulatory health and detect irregularities like arrhythmias or weakened blood flow. For example, a weak brachial pulse may indicate peripheral artery disease (PAD), which can lead to reduced blood flow to the extremities.

4. Emergency Situations

In trauma or cardiac arrest scenarios, checking the brachial pulse is often preferred over the carotid pulse due to its accessibility, especially in infants. The brachial pulse can be palpated on the inside of the upper arm, providing a reliable indication of circulation. 

Assessing the brachial pulse during CPR helps determine the effectiveness of chest compressions and whether the heart is adequately circulating blood. This method ensures faster response during resuscitation efforts.

Also Read: Common Symptoms of Heart Attack in Women

Common Mistakes When Checking the Brachial Pulse

While checking the brachial artery pulse is a simple procedure, some common mistakes are made, especially when first learning how to do it.

• Avoid using your thumb to check the pulse, as it has its pulse and can interfere with accurate detection.
• Applying too much pressure can occlude the artery, making it harder to detect the pulse. Use light pressure to feel the pulsation.
• Failing to extend the arm properly or pressing too close to the elbow joint may make it difficult to locate the pulse.

Also Read: Stroke vs. Heart Attack: What’s the Difference?

Mastering the Brachial Artery Pulse Location

Properly locating and assessing the brachial artery pulse is a vital skill in both routine healthcare and emergencies. Whether for CPR, blood pressure measurement, or assessing circulatory status, an accurate brachial pulse reading offers valuable information about a patient’s heart and vascular health. 

Mastering this technique ensures that healthcare professionals can detect subtle changes in pulse quality, which can be critical in early diagnosis and treatment.

For infants and children, where peripheral pulses may be harder to detect, the brachial pulse becomes particularly important. As clinical guidelines evolve, staying updated on best practices for pulse assessment enhances proficiency and contributes to better patient care. Timely and accurate pulse measurement can directly impact patient outcomes, making this an indispensable skill in medical practice.