palpation

Last reviewed 01/2018

The pulses should be felt as follows:

  • radial pulses, except in an infant where it may be easier to feel the brachial pulses. From these rate, rhythm and character should be noted.
  • although they should never be forgotten, the femoral pulses are usually best left until the end of the examination, as palpation will make most infants cry.
  • in the older child the carotid pulse may be felt; a thrill may be noted.

Palpation of the apex beat is next. To avoid missing the examiner's favourite - dextrocardia - a two handed approach may be used. The apex beat can usually be felt in the 5th, left intercostal space in the mid-clavicular line; the character of the beat should be noted.

Right ventricular heave should be examined for with the hand on the sternum.

During palpation of the chest any palpable heart sounds or thrills should be noted.

Palpation of the cardiovascular system is completed by examining for the liver.