How to check pulse and breathing rate
Other platforms explain it with text and video. In VMS you practice it on the patient.
Pulse and breathing rate look simple, but counting errors are common. A few rules make them reliable.
Step by step
Prepare
Clean your hands, introduce yourself and let the patient rest for a few minutes. [1]
Find the radial pulse
Use the pads of two or three fingers (not your thumb, it has its own pulse) on the thumb side of the wrist. [1]
Count
Regular pulse: 30 seconds times two. Irregular pulse: a full 60 seconds. [1]
Rhythm and strength
Regular or irregular, and strength: 0 absent, 1+ weak, 2+ normal, 3+ bounding. [1]
Apical pulse when needed
If the pulse is irregular or before some heart medicines, listen at the apex (fifth intercostal space, midclavicular line) for a full minute. [1]
Count breaths
Keep your fingers on the wrist so the patient thinks you are still taking the pulse, and count chest rises for 30 seconds (60 if irregular). [1]
Look at the breathing
Depth, pattern, effort, use of neck muscles and noises such as wheeze. [2]
Record
Write the rates, rhythm and anything abnormal, and report changes. [2]
Common errors
- Using the thumb to feel the pulse.
- Counting an irregular pulse for 15 or 30 seconds.
- Telling the patient you are counting breaths.
Practice it in VMS
In VMS you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
VMS cases that train this skill
Sources
- Open RN, Nursing Skills 2e (Chippewa Valley Technical College) (CC BY 4.0)
- OpenStax, Clinical Nursing Skills (CC BY 4.0)
Steps adapted from Open RN, Nursing Skills 2e (Chippewa Valley Technical College) and OpenStax, Clinical Nursing Skills, licensed under CC BY 4.0. VMS is not affiliated with these organizations. Updated: 2026-10-11.