A pulse is the rhythmic pressure wave created by the heart’s pumping action as it forces blood through the arteries. It is a direct indicator of heart rate, which is the number of times the heart beats per minute. Checking the pulse provides a simple, non-invasive way to assess the cardiovascular system’s status and rhythm. In emergencies, quickly locating a pulse is the first step in determining circulatory function. Understanding how to accurately and safely check this vital sign is a fundamental skill.
Identifying the Carotid Pulse Location
The carotid pulse is located on the neck because the artery is large and close to the skin’s surface. To locate this pulse point, sit upright and use the pads of the index and middle fingers. Avoid using the thumb, as it has its own strong pulse that could be confused with the measurement.
The goal is to find the groove between two major neck structures. Start by finding the windpipe (trachea) in the front center of the neck. Gently slide the two fingers sideways into the soft area next to the windpipe and underneath the large, angled neck muscle, the sternocleidomastoid. The most reliable spot is typically found around the level of the cricoid cartilage, a ring-like structure about midway up the neck.
Apply a light, steady pressure until the rhythmic throbbing of the carotid artery is felt. Only one side of the neck should ever be checked at a time.
Measuring and Calculating the Heart Rate
After locating the pulse, monitor the beats using a timepiece with a second hand or a digital timer. Use pressure firm enough to clearly feel the beat, but not so hard that blood flow is blocked. For a standard measurement, count the number of distinct beats felt over a period of 30 seconds.
This count is then doubled to calculate the heart rate in beats per minute (BPM). This method provides a quick estimate of the heart rate, assuming the rhythm is regular.
If the rhythm feels irregular, the most precise method is to count the beats for a full 60 seconds. For most healthy adults at rest, a normal heart rate range falls between 60 and 100 BPM. Highly conditioned athletes may have lower resting heart rates, sometimes as low as 40 BPM, which is normal for them.
Essential Safety Precautions
Checking the pulse in the neck requires specific safety measures because of the delicate structures located there. It is important never to press on both carotid arteries at the same time. Compressing both arteries simultaneously can severely reduce blood flow to the brain, potentially causing lightheadedness, fainting, or a stroke.
Avoid excessive pressure on the carotid artery, especially in the upper third of the neck. This area contains the carotid sinus, a pressure-sensitive zone that helps regulate blood pressure. Pressing too hard can stimulate the vagus nerve, causing the heart rate to slow dramatically and blood pressure to drop. This sudden change can lead to dizziness or temporary loss of consciousness. If the carotid pulse is difficult to find, using an alternative location like the radial artery in the wrist is a safer choice.