During the circulation assessment in an awake patient, which pulse should you check first?

• A. Radial pulse
• B. Carotid pulse
• C. Brachial pulse
• D. Femoral pulse

Answer: (A)

When assessing circulation in an awake patient, you start with the radial pulse because it’s the most accessible and least invasive way to get a quick read on perfusion. Palpating at the wrist lets you rapidly gauge heart rate, rhythm, and the presence of adequate blood flow to the extremities without moving or disturbing the patient. It also supports a quick bilateral comparison to spot any asymmetry. If the radial pulse is palpable and normal, you have a good initial indication that peripheral perfusion is adequate. If not, you can then move on to other pulses that reflect central or broader circulation, such as the carotid or brachial, as needed.