Take Your Own Pulse With a Stethoscope
It's a fact of life: some people's pulses are just more difficult to take by palpation (pressure on an artery with the fingers) than others. If you have been advised by your physician to monitor your heart rate regularly and are having difficulty taking your pulse this way, it will likely be easier to take it with a stethoscope instead. To learn how to do this, read on.
Contents
Steps
- Purchase a stethoscope if you do not already have one. You do not need an expensive one as you are only counting and do not need to listen to quality. Spending a max of 20-30 dollars for the double-tubed "Sprague" type will do just fine.
- You will also need something to keep track of time with in seconds. A WATCH WITH A SECOND HAND IS MUCH EASIER TO USE THAN A DIGITAL WATCH because you do not have to count the seconds, you can just look at where the second hand should end up on your watch at the end of the time that you want.
- To take your pulse, you will be listening to your heart through your chest. Depending on the quality of your stethoscope you can usually listen through about two T-shirt layers of clothing (just for the beats, not quality). Take any extra heavy clothing off if you cannot hear your heart clearly.
- Place the earpieces in your ears. Note that the earpieces of the stethoscope are usually angled and in order to hear correctly and have them be comfortable you need to place the tips in facing FORWARD, in the direction that you are looking. If they are not comfortable, you may gently bend them forward or backwards to get a good fit.
- The piece that goes on your chest is called the chestpiece. Many stethoscopes have chest pieces with two sides that can be rotated around the tubing to better hear high frequency and low frequency lung sounds,a diaphragm and a bell. When one is in use the other cannot be used. With the earpieces in your ears, GENTLY rub the diaphragm side (the one with the flat plastic piece) of the stethoscope and listen for a sound. If you do not hear a sound, turn the chest piece over (you should hear it click into position) and try again. This should resolve any issues.
- To position the chestpiece on your chest, find the imaginary line between your nipples. You want to put the chestpiece diaphragm side down on that line slightly to your left of center. Experiment to find where you can hear your heart best. If you are having trouble and still cannot find it it may be helpful to lie down while doing this.
- Get your timepiece ready to watch; we are now ready to count your heart beat for a given time period. When we listen to the heart, remember that it has TWO beats, which represent the succession of valves in your heart contracting to pump blood (lub-dub lub-dub). HOWEVER ONLY ONE OF THOSE BEATS IS COUNTED IN YOUR PULSE. The first beat is usually stronger and I recommend listening only to that beat and tuning the first one out.
- Look at the second hand on your watch/clock, and when the second hand hits one of the 5 minute markers start counting the beats through your scope. In a clinical setting we typically count the pulse for 30 SECONDS as this is the minimum that is considered accurate. As mentioned earlier, you do not need to note each time the second hand moves, keeping track of that is too much work! Instead, look at where the second hand WILL end up at the end of 30 seconds. For example, if you start counting at the "2" mark, the hand will have passed 30 seconds at the "8" marker, or if you start at 12, 30 sec. will be at 6. Stop counting beats when the second hand reaches the marker and 30 seconds have elapsed. If you would like to be even more accurate (because the pulse is not always completely regular), you may count beats for 1 minute.
- If you counted for an entire minute you are all set and have your pulse, but in most cases we now need to do a little math because pulse values are expressed in beats per minute (BPM). You counted the beats for 30 seconds, but as there are 60 seconds per minute you must multiply that by 2 to get beats per 60 seconds. For example, if I counted my pulse at 36 beats over 30 seconds, my pulse would be 72 because 36beats/30seconds = 72beats/60seconds. If, for some reason, you counted beats for only 15 seconds (as we sometimes do in moving ambulances because taking pulses is a PAIN in there), you would need to multiply by 4 as 15 x 4 = 60 = bpm.
- All done. Pulse does fluctuate relatively regularly, but if you think your pulse was unusually high or low (e.g. 15-20 bpm off your normal), you should definitely repeat this process to make sure you were accurate, and repeat successively until your measurements are relatively similar. And that's all there is to it.
Tips
- It's not a great idea to place your thumb over the bell (unused side) of the stethoscope when holding it because the thumb has its own pulse and could mess your count up. I like to hold it with my thumb and index fingers spread out and parallel, with the sides of the chestpiece in the space between them.
- If you don't want to take clothing off it is also possible to place the stethoscope over the brachial artery, at the space where your elbow bends. To do this, expose your elbow and outstretch your arm so it is flat and put the diaphragm down, you will have to gently and slowly press softer to harder on your arm until you hear your pulse. For this you count all beats.
- However, you should consider using the stethoscope on bare skin to prevent it from picking up the sound of rustling fabric. The fabric can also soak up the sound and make your heart sound faint.
- Note that when you listen to your heart you will also hear your lungs because you are (hopefully) breathing. Don't worry about this, you will tune it out soon enough, just concentrate on the beats. And certainly DON'T try to hold your breath as it will elevate your pulse temporarily and you will get an inaccurate reading.
Warnings
- be careful not to bump anything with the chestpiece of the stethoscope while it is in you ears, the sound will carry and this is loud and unpleasant!
- if you do happen to hear anything other than the standard "lub-dub" sounds when you are listening to your heart, it may be beneficial to talk to your doctor about them, especially if you are feeling unusually sick. This would include anything you hear between "lub" and "dubs" or anything particularly high-pitched. Listen to recordings of normal heart sounds online to get an idea what your heart should sound like (although note that there is variation).
