If the left radial pulse is nonpalpable, what is the next appropriate action?

• A. Recheck after 5 minutes
• B. Administer vasodilator
• C. Use a Doppler ultrasound stethoscope to auscultate the pulse.
• D. Apply heat

Answer: (C)

When a peripheral pulse can’t be palpated, the next step is to use a Doppler device to locate it. The Doppler ultrasound stethoscope detects blood flow that isn’t felt as a pulse by converting the movement of red blood cells into an audible signal. In practice, you apply a small amount of gel over the artery (often the radial or another accessible site), place the probe, and slowly move it until you hear a pulse sound. If you hear the signal, you’ve confirmed circulation in that limb and can document the finding and proceed with further assessment (comparing bilateral pulses, checking perfusion indicators, etc.). If no pulse is detected with Doppler, proceed with additional assessment of circulation (other pulses, limb warmth, capillary refill) and notify the clinician as needed.