A pulse check rapidly assesses circulation in an unresponsive individual. Emergency protocols prioritize speed and accuracy, as the time spent confirming circulation directly impacts the potential for a successful outcome. Understanding the precise time limit for this assessment is part of providing effective aid. This article outlines the definitive duration for checking a pulse and the subsequent life-saving measures that immediately follow.
The 10-Second Assessment
The maximum time dedicated to checking for a pulse in an unresponsive victim is strictly set at ten seconds by major resuscitation councils. This constraint exists because delaying chest compressions significantly reduces the chance of survival during cardiac arrest. If a pulse cannot be definitively felt within this brief window, rescuers must immediately proceed as if no pulse is present.
The preferred location for assessing circulation in an adult or older child is the carotid artery, found in the neck. This major vessel delivers blood to the brain and is often palpable even when peripheral pulses are too weak to detect. To check this pulse, two fingers should be placed in the groove between the trachea and the large muscle on the side of the neck closest to the rescuer.
Locating the Pulse in Different Age Groups
While the carotid artery is the standard for adults, the anatomical location for the pulse check changes based on the victim’s age. For infants (under one year of age), the recommended site is the brachial artery, located on the inside of the upper arm between the elbow and the shoulder.
The brachial site is used because infants’ necks are often short and padded, making the carotid pulse difficult to reliably locate. Lay rescuers could also inadvertently compress the delicate airway while searching for the carotid pulse. The brachial pulse is checked by gently placing two fingers on the inner bicep area and pressing lightly against the underlying bone.
For children (one year old up to the onset of puberty), the carotid artery remains the primary site, similar to adults. In emergency medical settings, the femoral pulse in the groin may be used if the carotid is inaccessible or unclear. Regardless of the location, the technique involves using the pads of two fingers, never the thumb, as the thumb has its own strong pulse that can confuse the assessment.
It is important to distinguish these emergency assessment sites from the radial artery, which is commonly used for self-assessment at the wrist. The radial pulse should not be used in an unresponsive patient, as it is a peripheral pulse that may disappear even with low blood pressure.
Immediate Action Based on Findings
Once the 10-second assessment is complete, the next steps are dictated by the presence or absence of a pulse and normal breathing. If no pulse is detected or the rescuer is uncertain, the protocol requires the immediate initiation of chest compressions. This transition is based on the principle that the risk of performing compressions on a beating heart is far less than the risk of delaying them when the heart has stopped.
Before starting chest compressions, the rescuer must ensure that emergency medical services have been called. The goal of compressions is to manually circulate blood to the brain and other vital organs until professional help arrives. If the victim is unresponsive, not breathing, and has no pulse, this sequence constitutes Cardiopulmonary Resuscitation (CPR).
If a pulse is clearly present but the victim is not breathing or is only exhibiting ineffective gasping, this is respiratory arrest. In this scenario, the heart is still functioning but the person is not moving air. The rescuer should provide rescue breaths without initiating chest compressions.
For an adult, rescue breaths should be administered at a rate of about one breath every five to six seconds. For children and infants, the rate is slightly faster, at one breath every three to five seconds. This intervention focuses on oxygenating the blood that the heart is still circulating.
If both a pulse and normal breathing are detected within the ten-second window, no compressions or rescue breaths are necessary. The victim still requires continuous monitoring and should be placed into the recovery position, provided there is no suspected spinal injury, to maintain an open airway and prevent aspiration of fluids.