Measuring a Pulse: Which is better?

[SRS131EMTFF 471]

This is a discussion I had with one of my friends a while ago:

What watch system works better when trying to measure a patients pulse:

-An analog watch with the seconds hand to tell you ok when it reachs X point it has been Z amount of time and the Patients pluse is Y

OR

-A digital watch with the seconds of course to measure the amount of ellapsed time?

Would trying to figure the amount of time on a digital be distracting you from measuring the patients pulse or would there be no downside

Is there any Pros or Cons for using a analog or digital time system

While I am not an EMT nor have I ever taken a pulse I would like to get my CFR and EMT some day and I would appreciate some opinons on the better system

This topic also comes from a debate I heard while listening to 2 EMTs from the Northern Westchester Area

[DOC22 1]

I've had my pulse taken at a few different Doctors' offices and they all cout the beats watching the second hand on the wall clock for fifteen seconds and multiply by four.

That seems to be the most popular (beast in 15 secs times 4)

Hope this helps.

[Guest]

Whatever you feel most comfortable with, really. Personally, i prefer a standard watch, only because i've never owned a digital watch. When i review skills with EMT candidates i always suggest a standard watch only because it seems that a seconds hand helps one visualize the time elapsing.

Gah - i would caution against 15 x 4!!! Always do the 30, it’s a lot more accurate and reliable in terms of guaranteeing regularity and the propper pulse rate!

Edited February 13, 2007 by 66Alpha1

[Guest partyrock]

To each their own. Counting while reading numbers at a different rate is hard. Kind of like someone shouting different numbers while you count something. The second hand works because it is based on positioning so the only numbers in your head are the pulse and digits you picked up from that girl in the diner.

15 x 4 has yet to fail me, but to each their own. Its no so much about getting 88 when the actual pulse is 80. Getting it right is good, but treat the patient not the numbers. Just because a patients pulse is 56, doesn't mean they're bradycardic. If he's a marathon runner sitting there watching TV with no complaints thats quite possibly normal. If on the other hand he is 60, suddenly easily tired, dizzy and light headed he's going to the ER no matter what his pulse is.

[Guest]

The only reason i cautioned is b/c i have seen some far out and groosly inaccurate pulses from people useing 15 x 4, naturally do whatever your most comfrtable with.

Just to reiterate what partyrock said, pulse will rarely be the sole factor in a treatment determination - but it, like everything else, is going to be a useful peice of the clinical puzzel that will help determine treatment.

[helicopper 1,050]

I've used both types of watches during my career - some have said that I even used a sundial but I steadfastly deny that!

As for 15x4 or 30x2 or 60 - depends on the nature of the call and the patient. If the patient has a cardiac history and their pulse is irregular I'm much more likely to measure a pulse for a full minute to determine the irregularity and rate as accurately as possible. For the majority of patients a shorter count and multiplication is fine.

I agree that the pulse is only one small piece of the assessment puzzle, too!

Tick tock!

[Guest alsfirefighter]

I only have worn a digital watch for work purposes for, well a long time. Gives me no problems.

I'm also with the rest of the gang as far as the 15 x 4 or 30 x 2 routine. I will generally use 15x4 to get a quick impression, I'll get the monitor on and then if I see something on tape I will palp for an extended period of time to see if what I see on paper is transpiring mechanically.

Just do me a favor...don't make some of the pitfalls I am seeing:

1. Do not put on a pulse ox and tell me the pulse...you don't know the clarity if it is truly regular or not.

2. Do not tell me the pulse off of the number from you automatic blood pressure machine. You should be getting a manual baseline set of vitals in the first place.

3. Do not tell me the "pulse" by the electronic heart rate of your "AED", because 1. as said you still need to feel it, 2. It is a violation of protocol to attach an AED to anyone other then an unresponsive patient.

All you BLS agencies with your fancy LP-12 "AED's" put the monitoring cables in the closet somewhere.