Elderly mom having difficulty getting accurate pulse reading prior to taking Digoxin

[mbdorsey]

Re-My 92 year old Mom who has A fib and takes warfarin and digoxin. She is supposed to take her pulse prior to taking her digoxin and if it is below 60 she is not to take it. Lately she has not been able to accurately do a manual reading so we have been trying an oximeter. Her reading is always fluctuating (sometimes dipping below 60and then rising above 60) which I am assuming is Afib. Is there a better way to accurately measure her pulse.

[rosyG]

my BP monitor records pulse rate too- would she be able to manage that. Also get her to try to take her pulse in her neck- not to press too hard!!

[mbdorsey in reply to rosyG]

Sorry I wasn’t clear ...she does have a pulse option too but it often..oscillates between going below and above 60 ...probably because of her afib...so not sure if she should take her digoxin in this situation. I’ll check on the neck option but think she may get confused..she tends to count the seconds not the pulse.thanks

[Hidden]

I wonder if she would find a stethoscope placed over the heart useful. There are plenty of cheap ones on Amazon, though the reviews suggest variable quality. I hope the suggestion does not seem too ridiculous.

[Kresta in reply to Hidden]

It’s a very sensible suggestion. I have persistent afib and sometimes the digital devices aren’t accurate. My doctor told me to check my pulse at my wrist or carotid artery and if it’s hard to pick up that way then to use a stethoscope. He is in his late sixties and was trained when digital devices weren’t around. He uses touch and his ears which some young doctors lack training in.

[Moonfairy1987]

Im also on tildiem and i have to watch my pulse rate doesnt fall under 50 i do this with heart rate monitor which measures pulse but have af my pulse is up and down often more higher than lower .

[Polski]

When I am in AF my pulse at my wrist is unreadable. I had two nurses in hospital unable to find it (I said I didn't have one!) on one occasion. Now I have a Kardia and can see what is happening I understand why! That gives me an average reading over half a minute. The result is always much higher than anything I could count, as the beat keeps moving around!

[momist in reply to Polski]

I'm with Polski on this, but I doubt that a 92 yo Mom would like using a Kardia. The stethoscope sounds like a good idea.

[Hertbeat321]

It is reasonable now to ask for a change in medication if checking the pulse has become difficult, have a word with either yr. cardiologist or gp, my brov was on digoxin and cardiologist changed it to a beta blocker, which she doesn’t have to check her pulse beforehand.

[gragsdellforme]

As a retired nurse we were always required to take an apical pulse before giving digoxin. (with a stethoscope over the heart) A pulse ox will give you a pulse rate. I use this small device to check my O2 saturation .

[momist in reply to gragsdellforme]

gragsdellforme , since the pulse ox uses LEDs to measure redness of the finger, hence O2, it will surely be confused by AF and not get a reliable pulse reading during that condition?

[gragsdellforme in reply to momist]

Thanks momist. I just use it to check O2. I do not have AF so I wasn't aware. but that does make sense.

[Offcut]

I have an oxymeter and when I am in AF it will not read my pulse at all. If the wrist is not working out try the neck?