Why Doctors Check Your Wrist: Pulse, Blood Pressure & Reflex Assessment

Placing fingers on the wrist serves multiple diagnostic purposes in a single gesture.

1. Radial Pulse Assessment

• Rate: Normal 60–100 bpm (athletes 40–60). Tachycardia/bradycardia clues.
• Rhythm: Regular vs irregular (AFib, ectopy).
• Character: Bounding (high CO, fever), thready (shock, dehydration), pulsus paradoxus (tamponade, asthma), bisferiens (AR+AS).
• Symmetry: Compare both sides — asymmetry suggests subclavian stenosis, thoracic outlet, dissection.

2. Blood Pressure (Manual)

• Stethoscope over brachial artery (antecubital), but radial palpation estimates systolic: inflate cuff until radial pulse disappears → approximate systolic.
• Confirms cuff size/position.

3. Allen Test (Before Radial Artery Cannulation/ABG)

• Occlude radial + ulnar → open hand → release ulnar → color return <5 sec = adequate collateral flow.

4. Other Assessments

• Skin turgor/temperature: Dehydration, shock, peripheral perfusion.
• Capillary refill: Finger pulp compression → return <2 sec normal.
• Tremor: Resting (Parkinson's), postural (essential, hyperthyroid), intention (cerebellar).
• Wrist range of motion / tenderness: Trauma, arthritis, carpal tunnel (Tinel's at wrist).

Not Typically Done at Wrist

• Heart murmurs (auscultated at precordium).
• Ear exam (otoscope).

The wrist is a window into cardiovascular, neurological, and hemodynamic status — efficient, non-invasive, information-rich.