The carotid pulse, located on the side of the neck, is one of the most accessible and strong pulse points on the human body. This location is often chosen for checking a heart rate, especially when the pulse at the wrist (radial pulse) is difficult to detect. The large common carotid artery runs through the neck, supplying oxygenated blood directly to the brain and head, making its pulsation a reliable indicator of heart function. Its strength and superficial location make it a common site for quickly assessing circulation, particularly in emergency situations.
Identifying the Carotid Pulse Location
The carotid artery runs vertically up the neck, situated in a soft groove between two distinct structures. To locate the pulse, first identify the trachea (windpipe), the firm, central tube in the front of the neck. Gently slide your fingers laterally from the center of the trachea toward the side of the neck. The correct spot is in the hollow between the trachea and the large, rope-like sternocleidomastoid muscle that runs from behind the ear to the collarbone. The pulse is typically felt around the level of the cricoid cartilage, located about midway up the neck.
The common carotid artery is located just beneath the surface in this groove. Feeling for the pulse requires placing the pads of your fingers in this soft area and applying very light pressure. This anatomical placement, medial to the neck muscle and lateral to the windpipe, ensures the pulse is often palpable, even when blood pressure may be low.
Step-by-Step Procedure for Checking the Pulse
To begin the assessment, use the tips of your index and middle fingers, as these are the most sensitive for detecting a pulse. It is important to avoid using your thumb, as the thumb has its own strong pulse that could be confused with the one you are trying to measure. Once the correct location is found, apply gentle, but firm, pressure until you feel the distinct rhythmic thumping of the artery. Applying too much force can compress the artery, leading to an inaccurate reading or obstructing blood flow.
After locating the pulse, use a watch or clock with a second hand to time the count. A common method is to count the number of beats felt over a 15-second interval. To calculate the heart rate in beats per minute (BPM), multiply this 15-second count by four. For a more accurate reading, especially if the pulse feels irregular, extend the count to 30 seconds and multiply the result by two, or count for a full 60 seconds.
Why Caution is Necessary When Checking the Neck Pulse
Checking the pulse in the neck requires specific safety considerations due to the presence of sensitive structures. You must never attempt to check the carotid pulse on both sides of the neck simultaneously. Compressing both carotid arteries at the same time can dangerously reduce the flow of oxygenated blood to the brain, which may lead to dizziness, lightheadedness, or fainting. This action compromises cerebral blood flow and is a significant risk.
The common carotid artery contains a specialized area called the carotid sinus, which is a collection of pressure receptors located near the top of the artery. Pressing too hard or massaging this area can stimulate the vagus nerve, causing the heart rate to slow down significantly (vagal stimulation). This sudden drop in heart rate and blood pressure can be dangerous, particularly in older individuals. Checking the carotid pulse is reserved for situations where other pulse points are not easily found, or when assessing an unresponsive individual.