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Introduction and Pulse
Foundation Information
A
state of equilibrium (balance)
within the body maintained
through the adaptation of body
systems to changes in
either the internal
or external environment.
 To
better understand
homeostasis watch the
2 videos on the
class website
 Can
lead to shock
 Life-threatening medical condition as a
result of insufficient blood flow throughout
the body
 Often accompanies severe injury or illness
 Can lead to
 Hypoxia- lack of oxygen in tissues
 Heart attack
 Organ damage
 Death
 Requires immediate treatment as
symptoms can become worse quickly
 Signs
and symptoms of shock
 Rapid weak pulse
 Pale, blue/grey, cold/clammy skin
 Nausea and thirst
 Rapid shallow breathing
 Uncounsciousness
 Treatment
of shock
 Treat cause of shock first
 Raise and support legs
 Keep injured person warm
 Call EMS
 Calm and reassure injured person
 Monitor constantly
 Vital
signs are objective measurements
that provide data to determine a persons
state of health
 Pulse
 Respiration
 Blood
Pressure
 Temperature
 In
addition, height and weight are also
taken as they can provide insight on the
health of an individual.
 Number
of times the heart contracts per
minute. Pulse is measured in beats per
minute and is abbreviated bpm. The medical
abbreviation for pulse is P.
 Fitness



Professionals are concerned with
Resting HR
Exercise HR
Recovery HR
 Normal
age.
 For
pulse rate varies depending on
the healthy adult the normal resting
pulse ranges from 60 to 100 beats per
minute
 Average is 70 to 80 bpm
Tachycardia
is characterized as a
fast heart rate which is more than
100 beats per minute. This may
indicate a patient has some sort of
heart disease or the person just
finished with vigorous exercise.
Bradycardia
is characterized as an
abnormally low heart rate which is
fewer than 60 beats per minute.
This may occur during sleep or
with trained athletes.
 Pulse
is measured by applying moderate
pressure on arteries with the sensitive
pads located on the tips of the index and
middle fingers
 Arteries:
Carry blood away from the
heart to the rest of the body. The blood
is typically oxygenated*.
 Veins:
Carry blood back to the heart.
The blood is typically deoxygenated*.
 *What
body system will cause the veins and
arteries to flip their oxygen content?
Write down an answer, you’ll get
the correct answer during the class
discussion. It’s okay if you’re
incorrect, at least you tried!
 If
you took all the blood vessels out of
an average child and laid them out in a
line, the line would stretch over 60,000
miles.
 An
adults would be closer to 100,000
miles
Manual
Palpation
Telemetry (Heart Rate
Monitor)
Electrocardiogram
3
Common Sites
 Radial
 Brachial
 Carotid
 Lightly
press the index and middle fingers
against the radial artery in the grove on
the anterior surface of the lateral wrist
closest to the thumb
 Located
in a groove between the biceps
and triceps muscles on the medial side of
the arm. This location is also used for the
auscultation of blood pressure
 The
action of listening to sounds from the
heart, lungs, or other organs, typically with a
stethoscope, as a part of medical diagnosis.
 Press
fingers lightly along the medial
border of the sternocleidomastoid muscle
in the lower neck region. Should only be
used in unable to palpate pulse in the
other sites.
Brachial
Carotid
Radial
 May
lead to an underestimation of true
heart rate because baroreceptors on the
carotid sinus region become stimulated
when touched.
 May
reflexively reduce the client’s heart
rate as the baroreceptors sense a false
increase in blood pressure. This is known
as the baroreceptor reflex.
 Sensors
located in the blood vessels.
 Sense
blood pressure and relay the
information to the brain so that a proper
blood pressure can be maintained.
 Baroreceptors
are located in the carotid
sinus.
 For
a better understanding watch the video
on the class webpage
Locate anatomic site
 Gently press down with 2 fingers over the
palpation site
 Count the number of pulsations for a specific
time period
 Begin counting the first pulsation as 1


Determine heart rate based upon the number of
pulsations in a given time period. Accuracy of
heart rate increases with longer palpation times
10 seconds = multiply number of pulsations by 6
 15 seconds = multiply number of pulsations by 4
 30 seconds = multiply number of pulsations by 2


Correct answers will be provided at the end of
the slideshow. Remember to include BPM

22 pulses in a 15 second count

66 pulses in a 30 second count

18 pulses in a 10 second count

Correct answers will be provided at the end of
the slideshow. Remember to include BPM

43 pulses in a 15 second count

67 pulses in a 30 second count

26 pulses in a 10 second count
Temporal
Femoral
Artery
Popliteal
Dorsal
Artery
Artery
Pedis
 Clients
and athletes may wish to monitor
their heart rate during exercise.
 In
order to effectively utilize heart rate
as a measure of intensity the pulse check
must be taken immediately after vigorous
(intense) exercise.
 It
is important to continue moving while
taking the pulse to prevent blood from
pooling in the extremities and causing
light-headedness.
 Occurs
when the walls or valves in the leg
veins do not work effectively and make it
difficult for the blood to return to the
heart.
 Occurs
after exercise because the muscles
help push blood back to the heart when
they contract. Following exercise the
muscles stop putting pressure on the veins
and causes blood to pool in the lower
body.
 Can
lead to hypotension, dizziness and
possibly passing out.
 Also
occurs in people with heart disease
and poor circulation.
Normal
Level 1
Level 2
Level 3
 When
measuring exercise heart rate take
the pulse for either 15 seconds and
multiply by 4 or 30 seconds and multiply
by 2 to convert it to a 1 minute value
(bpm).
 The
30 second count may be more
accurate, but typically the 15 second
count is used because heart rate may
decrease rapidly.
 When
clients experience
difficulty in palpating the pulse
the use of a heart rate monitor (also
known as telemetry) as a learning tool to
check the accuracy of the palpated heart
rate.
 With
telemetry the participant wears an
electronic heart rate monitor strapped to
his or her chest. Heart rate is then
transferred to a watch.
Benefits
1. Gives relatively accurate results
2. No need to stop activity to determine
heart rate
3. Client is able to see where the
heart rate is at any time which can
provide extra motivation.
 Electrocardiograms
can also be used to
monitor heart rates. Electrodes are placed
on the skin of the chest which measures the
electrical activity of the heart. Although,
they are more
likely to be used
in a cardiac
rehabilitation
setting versus a
personal training
setting.
 Beta-blockers
are medications prescribed for
hypertension which significantly decreases
resting heart rate and may affect exercise
response to heart rate.
 Correct
answers will be given at the end of
the slideshow
 Resting
Pulse: 78 beats per minute
 Exercise
Pulse: 168 beats per minute while
performing 1.5 mile run test. Pulse taken at
1 mile mark.
 Recovery
Pulse:136 beats per minute, 1
minute after Queens College Step Test
 Your
heart beats about 35 million times in a
year. During an average lifetime, the human
heart will beat more than 2.5 billion times.
 The
average healthy mouth produces about
600 milliliters of saliva each day. That's
enough to fill a 12-ounce soda bottle.

Approximately 80-90% of what we perceive
as "taste" actually is due to our sense of
smell.
 Red
blood cells may live for about four
months circulating throughout the body,
feeding the 60 trillion other body cells. Red
blood cells make approximately 250,000
round trips of the body before returning to
the bone marrow, where they were born, to
die.

22 pulses in a 15 second count
 22

66 pulses in a 30 second count
 66

X 4 = 88 BPM
X 2 = 132 BPM
18 pulses in a 10 second count
 18
X 6 = 108 BPM

43 pulses in a 15 second count
 43

67 pulses in a 30 second count
 67

X 4 = 172 BPM
X 2 = 134 BPM
26 pulses in a 10 second count
 26
X 6 = 156 BPM
 Resting

Pulse:
Date, Time Resting P was measured at 78 bpm
and is WNL. Signature with title
 Exercise

Pulse
Date, Time While performing the 1.5 mile run
test, P was recorded at the 1 mile mark and was
168 bpm. Signature with title
 Recovery

Pulse
Date, Time Recovery Pulse was taken 1 minute
following the Queens College Step Test. P was
recorded at 136 bpm. Signature with title.