A pulse is the rhythmic expansion and contraction of an artery with each heartbeat. Monitoring the pulse rate, or the number of heartbeats per minute, offers valuable insights into an individual’s cardiovascular health. Different locations on the body allow for pulse assessment, each serving distinct purposes.
Understanding the Carotid Pulse
The carotid pulse is located in the neck, on either side of the windpipe. To find it, place your index and middle fingers in the groove between the trachea and the large neck muscles, just below the jawline. Use gentle pressure, as pressing too hard can obstruct blood flow or stimulate the carotid sinus, potentially slowing the heart rate.
The carotid pulse is frequently used in emergency situations, particularly for assessing unconscious adults and older children. Its accessibility and strong palpability make it a reliable site to check for circulation, even when blood pressure is low. During cardiopulmonary resuscitation (CPR) assessment, the carotid pulse is checked for 5 to 10 seconds to determine if the heart is pumping blood.
For safety, never check both carotid arteries simultaneously. Compressing both arteries at once can significantly reduce blood flow to the brain, potentially causing serious complications. Always assess one side of the neck at a time to maintain adequate cerebral circulation.
Understanding the Brachial Pulse
The brachial pulse is located on the inner side of the upper arm, between the elbow and shoulder. To locate this pulse, extend the arm slightly with the palm facing upward. Place your index and middle fingers just above the crease of the elbow, on the inner arm. Gentle but firm pressure is often needed to feel the pulsation.
This pulse point holds significance for infants during emergency assessments, such as infant CPR. In newborns and very young children, the carotid artery can be difficult to locate due to their smaller anatomy, making the brachial pulse a more reliable site for evaluating cardiac function. When checking an infant’s pulse, a very light touch is necessary.
The brachial pulse is also widely used for taking blood pressure measurements in adults. The blood pressure cuff is wrapped around the upper arm, and the stethoscope is placed over the brachial artery. This allows healthcare providers to listen for sounds indicating systolic and diastolic blood pressure readings.
When to Use Each Pulse Point
The choice between assessing the carotid and brachial pulse depends on the individual’s age and the specific situation. The carotid pulse offers general accessibility and is often more palpable in adults, making it a primary choice when rapid assessment of circulation is necessary, especially during emergencies. In contrast, the brachial pulse is preferred for infants, where the carotid artery is less distinct and harder to find.
In emergency situations involving unresponsive adults or older children, the carotid pulse is the preferred site for checking circulation. During a suspected cardiac arrest, quickly locating a carotid pulse helps determine if chest compressions are needed. This site is chosen because the carotid artery is a large vessel that carries blood directly to the brain, and its pulse can often be felt even when peripheral pulses are too weak to detect.
For infants, typically those under one year of age, the brachial pulse is the recommended site for emergency pulse checks. An infant’s anatomy makes the brachial artery easier to isolate and palpate accurately on the inner upper arm. This ensures a more reliable assessment of their circulatory status during critical moments, such as infant CPR.
Beyond emergencies, the brachial pulse plays a role in routine health assessments. It is the standard location for measuring blood pressure in adults using a sphygmomanometer. The upper arm’s structure allows for effective compression by a blood pressure cuff, enabling precise measurement. While the carotid pulse is reserved for emergency assessments in adults and older children, the brachial pulse serves as the primary site for infant pulse checks and routine blood pressure monitoring.