Why the Test is Performed
Measuring the pulse gives important information about your health. Any change from your normal heart rate can indicate a health problem. Fast pulse may signal an infection or dehydration. In emergency situations, the pulse rate can help determine if the person's heart is pumping.
Pulse measurement has other uses as well. During or immediately after exercise, the pulse rate gives information about your fitness level and health.
How the Test is Performed
The pulse can be measured at areas where an artery passes close to the skin. These areas include the:
- Back of the knees
- Groin
- Neck
- Temple
- Top or inner side of the foot
- Wrist
To measure the pulse at the wrist, place the index and middle finger over the underside of the opposite wrist, below the base of the thumb. Press with flat fingers until you feel the pulse.
To measure the pulse on the neck, place the index and middle fingers just to the side of the Adam's apple, in the soft, hollow area. Press gently until you locate the pulse.
Once you find the pulse, count the beats for 1 full minute. Or, count the beats for 30 seconds and multiply by 2. This will give the beats per minute.
Normal Results
For resting heart rate:
- Newborns 0 to 1 month old: 70 to 190 beats per minute
- Infants 1 to 11 months old: 80 to 160 beats per minute
- Children 1 to 2 years old: 80 to 130 beats per minute
- Children 3 to 4 years old: 80 to 120 beats per minute
- Children 5 to 6 years old: 75 to 115 beats per minute
- Children 7 to 9 years old: 70 to 110 beats per minute
- Children 10 years and older, and adults (including seniors): 60 to 100 beats per minute
- Well-trained athletes: 40 to 60 beats per minute
Slow and Fast Heart Rates in Children
A child's pulse rate can be normal, fast (this is called tachycardia), or slow (this is called bradycardia).
In some forms of tachycardia, like Supraventricular Tachycardia (SVT) the heart rate might get over 220 beats/min. Or a child with bradycardia might have a heart rate less than 50 beats/min. A very fast or slow heart rate can be a medical emergency, especially if your child has any symptoms associated with it, like fainting (syncope), dizziness, or extreme irritability.
A heart rate above the upper limit of normal may be a sign of an underlying heart condition, or it can be a clue that other problems are going on in the body like an infection or a metabolic condition.
A pulse can also be regular or it can be irregular, which can be a sign of a heart problem.
Evaluation of an Abnormal Heart Rate
The ECG (also called an EKG) allows your doctor to not only verify your child’s heart rate, but also the rhythm, or electrical activity, of the heart, as well as provide clues on whether the heart is enlarged or working too hard. In some instances, your doctor may refer you to a doctor who specializes in heart conditions in children, called a pediatric cardiologist.
In addition to heart problems, your doctor may also check blood tests like a complete blood count or a thyroid test. This is because conditions like anemia or hyperthyroidism can cause a fast heart rate.
A high resting heart rate can also be associated with pain, dehydration, or a fever. If the high heart rate is attributed to these factors, then reversal of them should bring the heart rate back to the normal range. For example, if a child is sick with a high fever then he may have a high heart rate. Treating the fever with Tylenol (acetaminophen) and fluids should bring the heart rate back to normal.