Brachial Pulse: Location, How to Check, and Its Role in Emergencies

Did you know? 85% of infant CPR assessments begin with a brachial pulse check. That’s because it’s one of the most reliable ways to assess circulation in babies during emergencies. Knowing how to locate and check it quickly can make all the difference. You are rushing someone to the emergency room, only to find that their pulse suddenly drops. You check the wrist: nothing. Neck? Still nothing. But there’s one more place to check before it’s too late: the brachial pulse. This pulse, found on the inside of the upper arm, is a lifeline in situations where other pulse points fail, especially in infants, where the wrist and neck are harder to access or unreliable. It’s also the go-to site for checking blood pressure in adults and assessing circulation during CPR or shock.

According to the National Library of Medicine, the brachial pulse is one of the most commonly used sites for analyzing circulation in infants and during emergency evaluations. It is fast, reliable, and accessible if you know where and how to find it. Let’s learn more about the brachial pulse, its location, and the steps to check it below. 

What is a Brachial Pulse?

The brachial pulse is the rhythmic beat felt from the brachial artery, the major blood vessel that runs down the inside of your upper arm. This artery carries oxygen-rich blood from the heart to the lower arm and hand. It starts where the axillary artery crosses the major muscle (just below the shoulder) and continues down the upper arm until it branches into the radial and ulnar arteries near the elbow. While the radial artery supplies the wrist, the brachial artery lies deeper but offers a stronger signal, making it an ideal pulse check site when the wrist is too weak or inaccessible.

In clinical settings, it’s most commonly used for blood pressure readings, but it’s also essential in CPR for infants and in checking for signs of shock, dehydration, or poor circulation in all age groups.

Read More: How Artificial Intelligence is Revolutionizing CPR and First Aid

Where is the Brachial Pulse Located in Adults? 

The brachial artery pulse in adults is most easily located at the antecubital fossa. It is the bend of the elbow that you can see on your inner arm. This is where the brachial artery runs closest to the skin before branching into the radial and ulnar arteries. Any first responder or medical professional can follow the steps below to identify the brachial artery location in adults: 

Step 1: Position the Arm Correctly

Have the person sit or lie down comfortably. Ask them to extend their arm slightly and rotate the palm upward so the inner elbow, or antecubital crease, faces you. The arm should be relaxed, not rigid, to reduce muscle tension. You must also ensure that the person is seated or lying comfortably because any discomfort or stress can affect their blood pressure and pulse accuracy.

Step 2: Use Proper Finger Placement

Place the pads of your index and middle fingers just above the crease, on the medial side of the biceps tendon (closer to the body). You will be aiming for the shallow groove between the biceps and brachialis muscles.

Step 3: Apply Light, Steady Pressure

Press gently until you feel a rhythmic beat. Avoid pressing too hard, as excessive pressure can occlude the artery and make the pulse undetectable. If you don’t feel it right away, reposition your fingers slightly within that groove.

Step 4. Interpret The Pulse

The normal resting pulse rate for adults is between 60 and 100 beats per minute. You can estimate the heart rate easily by counting the pulse for 15 seconds and multiplying the number by four. This helps in the identification of any heart disease or underlying conditions in the future. 

Please note that it may take you a bit of practice to find the exact spot because the brachial artery runs along the arm’s medial side. However, the artery’s rhythmic pulse should become detectable easily if you put light pressure. This helps you detect conditions like cardiac amyloidosis and assess overall circulatory efficiency. 

Where is the Brachial Pulse Located in Infants?

 Step 1: Lay the Infant Flat
On their back, on a firm surface.

Step 2: Extend the Arm
Palm facing up.

Step 3: Locate Inner Upper Arm
Midway between shoulder and elbow.

Step 4: Use Two Fingers
Index and middle finger — not your thumb.

Step 5: Feel the Pulse Gently
Press lightly and count the beats.

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Tip: Best pulse point for infants under 1 year during CPR!

The brachial pulse in infants is usually located higher up the arm, almost near the middle of the upper arm. It is easier to detect than other pulse points like the radial or carotid, which are smaller and harder to palpate. Therefore, pediatric guidelines recommend checking the brachial pulse when assessing infants under one year of age during CPR or circulatory evaluation. To locate the pulse correctly, follow the steps accurately, as mentioned below: 

Step 1: Position the Infant

Lay the infant on their back in a flat, safe position. Gently extend one arm and rest it along their side with the palm facing up. Make sure the arm is stable, with minimal movement.

Step 2: Palpate the Upper Arm

Using your index and middle fingers, feel along the inner upper arm, midway between the shoulder and the elbow. The pulse is typically located between the biceps and triceps muscles, just above the elbow crease.

Step 3: Use Light Pressure

Infant arteries are delicate, and pulses may be faint. Press gently with your fingertips, just enough to create a slight skin indentation. Take your time; the beat may be subtle.

Step 4: Interpret the Pulse

An infant’s resting heart rate is higher than adult, often between 120 and 160 beats per minute. You can leverage the same method of counting for 15 seconds and multiplying by four to determine their heart rate.

Use a gentle touch when searching for the pulse because infants have delicate tissues and skin. Make sure to prioritize comfort and care for more accurate readings.

Read More: What Position Is Best To Be In During A Heart Attack?

What Factors Can Affect Brachial Pulse Readings? 

Accurate brachial pulse assessment depends on several internal and external influences. Understanding these can help you make more reliable judgments in clinical or emergency settings.

1. Physiological Factors

• Age & Normal Heart Rate: Heart rate varies by age—infants (100–160 bpm), children (70–120 bpm), and adults (60–100 bpm). Always compare the pulse to age-appropriate norms.
  
• Body Position: A relaxed arm with the palm facing up offers the best conditions. Tension or awkward angles may compress the artery and distort the reading.
  
• Hydration & Blood Volume: Dehydration or blood loss can lower blood pressure, making the pulse weak or difficult to detect.

2. Environmental & External Factors

• Temperature: Cold causes vasoconstriction, reducing pulse sensation. Warmth or fever leads to vasodilation, often making the pulse stronger.
  
• Body Fat Distribution: In individuals with high fat or muscle mass, the brachial artery may lie deeper, requiring careful pressure and finger placement.

3. Medical Conditions & Medications

• Blood Pressure Fluctuations: High blood pressure produces a strong, bounding pulse. Low pressure, especially during shock or severe illness, results in a faint or thready pulse.
  
• Medications & Fitness Levels: Beta-blockers may slow the heart rate, while stimulants or anxiety can increase it. Athletes often have lower resting pulses due to efficient heart function.
  
• Heart Rhythm Disorders: Irregular pulses may signal arrhythmias like atrial fibrillation or tachycardia. In such cases, always assess the pulse for a full 60 seconds.

When Should You Be Concerned About a Brachial Pulse?

While many variations in pulse are harmless, some can signal serious medical issues:

• Faint or Absent Pulse: May indicate severe hypotension, shock, or cardiac arrest. Immediate intervention is critical.
• Irregular or Skipping Beats: Can suggest arrhythmias, such as atrial fibrillation, and require medical evaluation.
• Very Rapid Pulse in Infants or Adults: Could point to fever, infection (sepsis), or dehydration. If paired with other symptoms like lethargy or confusion, seek emergency care.
• Asymmetrical Pulse (Only on One Side): May signal vascular obstruction or early signs of stroke.
• Thready, Weak Pulse After Trauma or Illness: Often associated with significant fluid loss or internal bleeding. Treat it as a red flag.

What is The Role of Brachial Pulse in Emergencies?

If you work in the clinical setting, you must know how to check the brachial pulse in patients. This applies especially when monitoring blood pressure and circulation in any victim. Let’s explore some of the most common uses and reasons why this pulse point is significant in emergencies: 

1. Essential for Blood Pressure Measurement: The brachial artery is used during BP checks with a cuff on the upper arm. Systolic pressure is heard first, diastolic last. It’s a key skill taught in BLS and ACLS courses.
2. Primary Pulse Check Site in Infants: It’s the go-to site for infants, where radial or carotid pulses are hard to find. Place 2–3 fingers between the elbow and shoulder. Check gently for 5–10 seconds.
3. Quick Circulation Indicator: A weak or thready pulse may mean shock or sepsis. A bounding one can suggest fever or anxiety. An absent pulse during CPR signals cardiac arrest or poor compressions.
4. Detects Medical Conditions: Fast pulses (tachycardia) may point to stress or infection. Slow pulses (bradycardia) can signal heart issues or be normal in athletes. Irregular rhythms are red flags.
5. Useful in Trauma & Shock: A palpable brachial pulse suggests systolic BP ≥80 mmHg. No pulse could indicate life-threatening hypotension. Quick checks guide field decisions fast.
6. Reassessing After Treatments: Check the brachial pulse after giving fluids or meds. It shows how well blood is circulating. Helps guide the next steps in emergency care.
7. Vital in Infant CPR: Used to monitor pulse during infant CPR. Check every 2 minutes for signs of recovery (ROSC). More accurate than carotid in babies.

Brachial Pulse vs. Other Pulse Points: When & Why to Use Each

Pulse points are used to assess circulation, monitor vital signs, and guide emergency care. Each pulse site serves a different clinical purpose depending on patient age, location, and condition. Let’s look at how the brachial pulse compares to other major pulse points and when to use each.

1. Brachial Pulse

• Location: Inside of the upper arm, between the biceps and triceps.
• Best Used For:
  • Infants (<1 year): Preferred site for checking circulation and during CPR (American Heart Association, 2020).
  • Blood pressure measurement: Site of auscultation when using a manual cuff.
• Why: Easily compressible against the humerus in infants; strong, central artery for accurate BP reading.

2. Carotid Pulse

• Location: Neck, lateral to the trachea.
• Best Used For:
  • Cardiac arrest in adults and children ≥1 year: Fast, central pulse check.
• Why: Close to the heart; remains palpable even during low cardiac output.
• Caution: Never palpate both carotids simultaneously—can trigger a vagal response or reduce cerebral perfusion.

3. Radial Pulse

• Location: Thumb side of the wrist.
• Best Used For:
  • Routine heart rate monitoring in conscious, stable adults.
• Why: Superficial, easily accessible.
• Limitation: May not be palpable in shock or hypotension (systolic BP < 80 mmHg).

4. Femoral Pulse

• Location: Groin crease, halfway between the pubic symphysis and anterior superior iliac spine.
• Best Used For:
  • Trauma, cardiac arrest, or assessing central perfusion.
• Why: Central artery, useful when radial is not palpable.
• Note: Can also be used for cannulation in advanced procedures (e.g., arterial line placement).

5. Popliteal Pulse

• Location: Behind the knee, deep in the popliteal fossa.
• Best Used For:
  • Assessing peripheral circulation, especially in suspected lower limb arterial disease.
• Why: Indicates femoral artery patency.

6. Dorsalis Pedis & Posterior Tibial Pulses

• Location: Top of the foot (dorsalis pedis); behind the medial malleolus (posterior tibial).
• Best Used For:
  • Peripheral vascular assessment in diabetics or patients with PAD.
• Why: Reduced or absent pulse may indicate arterial compromise.

Using the right pulse point depends on context, but when it comes to infants or blood pressure measurement, the brachial pulse is the most reliable and clinically appropriate choice. Its accessibility and central location make it indispensable in both emergency and routine care.

Master the Brachial Artery Pulse Location!

You must learn how to locate and analyze the brachial pulse if you are a healthcare professional or first responder. It is often considered to be a key skill in both routine healthcare and emergencies. An accurate brachial pulse provides you with valuable information about a patient’s heart and vascular health. This is beneficial for procedures like CPR, blood pressure measurement, or assessing circulatory status. 

Explore our ACLS certification course to master this and other life-saving skills. 

Add an FAQ section. 

FAQs

1. Why is the brachial pulse preferred in infants during CPR?
Because it’s easier to locate and more reliable than the carotid or radial pulse in infants under 1 year. The brachial artery is large and lies close to the surface in the upper arm.

2. What does a weak brachial pulse indicate?
A thready or weak pulse may suggest shock, low blood pressure, or blood loss. It often requires immediate medical evaluation, especially in emergencies.

3. Can you check the brachial pulse with your thumb?
No, avoid using your thumb as it has its own pulse and can give false readings. Always use your index and middle fingers.

4. What’s the easiest way to locate the brachial pulse in adults?
Find the inside of the elbow crease and slide your fingers medially beside the biceps tendon. Apply gentle pressure until you feel the rhythmic beat.

5. How often should you check the brachial pulse during infant CPR?
Every 2 minutes to assess for return of spontaneous circulation (ROSC). It helps determine if compressions or interventions are effective.