Locating the Radial Pulse: Anatomic Landmarks and Proper Technique

The radial artery is the standard site for pulse assessment due to its superficial accessibility.

Anatomic Location

• Wrist: Anterior (volar) aspect, lateral to the flexor carpi radialis (FCR) tendon.
• Landmarks: ~1–2 cm proximal to the wrist crease (radiocarpal joint), at the level of the scaphoid tubercle.
• Relation: Between the FCR tendon (medial) and the radius (lateral); covered only by skin, fascia, and the superficial palmar branch of the radial nerve.

Palpation Technique

1. Patient forearm supinated, slightly flexed, supported.
2. Use index and middle fingertips (not thumb—it has its own pulse).
3. Apply light pressure; increase until pulse felt; avoid occluding the artery.
4. Count for 30 sec ×2 (regular) or 60 sec (irregular).
5. Assess rate, rhythm, amplitude, contour.

Clinical Pearls

• Absent radial pulse → check brachial/femoral; consider hypotension, aortic dissection, radial artery occlusion (post-catheterization).
• Allen test assesses ulnar collateral flow before radial artery cannulation.
• Radial artery catheterization: Seldinger technique; continuous BP monitoring, frequent ABG access.