Today, November 15, 2018, I embark on a Project which I dub as Project Pulse Rate. I will teach my patients on how to feel and count their radial pulse rate. This will be part of my Patient Education and Empowerment Program. A lot of patients do not know how to feel and count the radial pulse rate.
The radial pulse is usually felt just inside the wrist below the thumb by placing two or three fingers lightly upon the radial artery. After feeling the pulse, the patients are asked to check the regularity or irregularity of the rhythm or beat. The patients are also asked to count the pulse beats in one minute using the second hand of a watch as illustrated. (Alternately, they can count the pulse beat in 15 seconds and then multiply by 4 to get the rate in one minute.) The normal pulse rate is said to be 60 to 100 per minute. Above 100 per minute is considered rapid or tachycardia. Below 60 per minute is considered slow or bradycardia.
In my Project Pulse Rate, I will focus or prioritize on patients with a thyroid concern or problem.
Feeling and counting the pulse rate is very important in patients with a thyroid concern or problem.
It helps in the diagnosis of a thyroid problem (tachycardia with pulse rate being more than 100 per minute is used to suspect hyperthyroidism in a patient with a possible thyroid problem).
It helps in monitoring the course or outcome of treatment of hyperthyroidism – whether the pulse rate is decreasing with medications.
It helps in monitoring the side effects of thyroid hormones being administered. High dose of thyroid hormones such as levothyroxine can cause tachycardia (pulse rate of more than 100 per minute). Patients can be asked to monitor their own pulse rate while taking levothyroxine with an advice to decrease the dosage when there is tachycardia.
At times, patients complain of palpitations. Palpitations are a feeling or sensation or awareness of the heart beating. It is most commonly felt in the chest. They may feel like the heart is racing, thumping or skipping beats.
Almost everyone has had palpitations at some time in their life. They are usually associated with an abnormal heart rhythm (arrhythmia). They may or may be associated with a tachycardia.
Palpitations may have no obvious cause, but can be triggered by:
- physical activity
- emotional stress
If a patient develops palpitations while on levothyroxine, it is best that they feel and count the pulse rate. If the pulse rate is rapid, then they can be advised to reduce the dosage of the medicine. If the palpitations are not associated with tachycardia, they may continue with the usual dosage and observe.
To my beloved patients, are you ready to learn how to feel and count your pulse rate? It is easy. It takes less than one minute to do this. It is something worth learning.
Project Pulse Rate
Patient Education and Empowerment Program
Retrieved this old file of 2013 (April 19) with following caption:
“I empower my patients to take care of themselves and relatives to help their relatives through education. Here, counting the pulse rate to monitor the effect of the medicines being taken for hyperthyroidism (or toxic goiter).”
So, I have been teaching patients how to count pulse rate before, all along.
More past pictures: