When a person is found unresponsive, a rapid assessment of their circulatory status is essential for determining the need for immediate intervention. Unconsciousness signals a potentially life-threatening emergency, requiring the rescuer to quickly ascertain if the victim’s heart is effectively circulating blood. The method used to check for a pulse directly informs the next steps in emergency care, particularly whether to initiate chest compressions. The choice of the pulse point and the technique used are crucial for the victim’s chances of survival.
The Central Pulse Point for Unconscious Victims
The standard location for checking a pulse on an unresponsive adult is the carotid artery, situated on either side of the neck. This vessel is classified as a central pulse because it is one of the closest major arteries to the heart. Major resuscitation protocols designate the carotid artery as the primary site for pulse checks in emergency scenarios. Because the carotid artery supplies oxygenated blood directly to the brain, a detectable pulse here indicates that blood pressure is sufficient to perfuse the brainstem. Identifying the presence or absence of a carotid pulse immediately precedes the decision to begin chest compressions.
Proper Technique for Checking the Carotid Pulse
To locate the carotid pulse, the rescuer should first locate the victim’s trachea, or windpipe, in the center of the neck. The tips of the index and middle fingers should then be gently slid into the groove between the trachea and the large muscles on the side of the neck. Use only the index and middle fingers, as the thumb has a noticeable pulse that could be misinterpreted as the victim’s heartbeat. The pulse check must be limited in duration to prevent delays in initiating life-saving measures. A rescuer should spend no more than 10 seconds attempting to find and confirm the pulse; if no pulse is definitively felt, the absence of a pulse is assumed, and resuscitation should begin immediately.
Why Peripheral Pulses Are Unreliable in Emergencies
Other pulse points, such as the radial pulse at the wrist or the pedal pulses in the feet, are referred to as peripheral pulses. These locations are unreliable for assessing circulation in an unconscious victim, especially during conditions like shock or cardiac compromise. In these situations, the body initiates peripheral vasoconstriction, a defense mechanism that narrows blood vessels in the extremities. This process redirects blood flow away from the limbs and toward vital organ systems like the heart and brain. Consequently, a victim experiencing shock may still have a heartbeat, but the radial pulse may be too weak or entirely absent due to this shunting of blood.
Immediate Steps After Pulse Assessment
If the carotid pulse is clearly present, the immediate focus shifts to managing the airway and breathing. The victim should be monitored closely; if they are breathing normally but remain unconscious, they should be placed in the recovery position. This position helps maintain an open airway and prevents aspiration. If the rescuer cannot definitely feel a pulse within the 10-second limit, the situation is treated as a cardiac arrest. The emergency response system must be activated immediately, and chest compressions should be initiated at a rate of 100 to 120 per minute to circulate blood until professional help arrives.