Checking for a pulse is a fundamental step in determining if immediate life-saving interventions, such as cardiopulmonary resuscitation (CPR), are necessary for a child. This assessment provides information about the child’s circulatory status. Understanding the correct methods for checking a pulse in children and infants is important for anyone responding to such an emergency.
Key Differences in Pulse Checks for Children and Infants
The approach to checking a pulse varies depending on the age of the individual, primarily due to anatomical differences. An “infant” is generally defined as a child under one year of age, while a “child” refers to individuals from one year of age up to the onset of puberty. For infants, the preferred site to check a pulse is the brachial artery. This artery is located on the inside of the upper arm, midway between the elbow and the shoulder.
For children aged one year to puberty, the carotid artery is the primary site for pulse assessment. This artery is found in the neck. While the femoral artery, located in the groin, can also be used for both infants and children, it is less commonly taught for general public use due to its location and the potential for difficulty in rapid identification.
How to Check a Child’s Pulse
To check a child’s pulse using the carotid artery, first position the child on their back, if possible, to allow easy access to their neck. Locate the trachea, or windpipe, in the middle of the child’s neck. Gently slide two or three fingers (not your thumb) into the groove between the trachea and the large muscles on the side of the neck closest to you. This specific location allows for optimal detection of the carotid artery’s pulsations.
Apply gentle pressure in this area, being careful not to press too hard, as excessive pressure can compress the artery and make the pulse difficult to feel or even obstruct blood flow. You should feel for a pulse for no more than 10 seconds. A normal pulse will feel strong and regular, indicating adequate circulation. If the pulse feels very weak, thready, or is entirely absent, it suggests a significant circulatory problem that requires immediate attention.
When to Begin CPR
If, after checking for a pulse for no more than 10 seconds, you do not feel a pulse, or if the pulse is very weak, slow, or irregular, immediate action is required. Specifically, if the pulse rate is less than 60 beats per minute and the child shows signs of poor perfusion (such as pale skin, bluish lips, or unresponsiveness), CPR should be initiated without delay. These signs indicate that the heart is not effectively circulating blood to the body’s vital organs.
It is crucial to call for emergency medical services (such as 911) as soon as you recognize the need for CPR. If you are alone, perform approximately two minutes of CPR before pausing to call for help, ensuring continuous blood flow to the child’s brain and other organs. If another person is present, one person can begin CPR while the other calls for emergency assistance. While this guide focuses on pulse assessment, starting chest compressions at a rate of 100-120 compressions per minute is the immediate next step if a pulse is absent or inadequate.