can you do the calculation

Activity 8: Measuring Pulse deficit (Simultaneous Apical-Radial Counts) Determine the pulse deficit (apical rate minus radial rate) to assess whether every cardiac contraction generates a palpable peripheral pulse. Materials * Stethoscope, timer with seconds, alcohol-based hand rub, disinfectant wipes, data sheet. Pulse deficit is the difference between the apical and radial pulse. Two people will need to be present to measure the pulses, along with the stethoscope and timing device. Instructions O Explain the procedure and obtain consent. Have the participant rest seated for 5 minutes, arm supported, palm up. Perform hand hygiene; clean stethoscope earpieces/diaphragm. Pair Role A: Auscultate the apical pulse (60 seconds) at the left 5th intercostal space, midclavicular line (mitral area). B: Palpate the radial pulse for 60 seconds (pads of index/middle fingers; do not use the thumb). Once the minute is complete subtract your radial pulse from your apical pulse. Your apical and radial pulse rates will be the same if everything is working as it should. Your apical pulse rate will never be lower than your radial pulse rate. If the radial pulse is slower than the apical pulse, that indicates a pulse deficit. A pulse deficit can indicate a problem with the efficiency of heart or cardiac function. A pulse deficit greater than 4 might indicate some physiological problem. Atrial fibrillation (Afib) is a common arrhythmia that can result in a rapid, irregular heart rate. This causes a pulse deficit, because each ventricular contraction may not be sufficiently strong to transmit an arterial pulse wave through the peripheral artery. Assessment of the radial pulse in isolation will not be an accurate reflection of the actual heart rate. Other causes for a pulse deficit include atrial flutter. In the absence of cardiac monitoring, the assessment of the apical beat (together with the radial pulse) is an important aspect of the management of the patient with Afib. A wid deficit indicates inefficient cardiac contraction. Calculate: Simultaneous measurement of apical and radial pulse e apical-radial pulse O Pulse deficit = Apical rate (bpm) - Radial rate (bpm) = Interpretation (guide) Normal: 0-1 beat difference. 9 Deficit 22-4 beats suggests some ventricular contractions are pulse (e.g., atrial fibrillation, frequent PVCs, low stroke volume) Is it greater than 4? NOTE: The measurements are for learning purpose only. not generating a palpable peripheral