Which fingers are recommended to palpate the peripheral pulse, and why should the thumb be avoided?

• A. The index and middle fingers; to avoid the thumb's own pulse being mistaken
• B. Any finger; there is no reason to avoid the thumb
• C. The ring finger; it provides best sensitivity
• D. The thumb; it has its own pulse

Answer: (A)

The key idea is to use the pads of the index and middle fingers to palpate a peripheral pulse. These fingertips are the most sensitive for feeling a pulse and provide good discrimination of rate, rhythm, and strength. The thumb should be avoided because it has its own arterial pulse; relying on it can cause you to mistake your own pulse for the patient’s, leading to an inaccurate reading. Using two fingers also helps distribute pressure and improves the ability to detect the pulse without occluding it. Keep the touch light, and apply just enough pressure to feel the artery without pressing so firmly that you dampen the pulse.