An unconscious child represents a high-stress medical emergency requiring rapid, accurate assessment. Knowing the correct location and technique for checking a pulse can save precious seconds, potentially making the difference between life and death. The procedure for assessing circulation follows specific protocols designed to detect a heartbeat quickly and reliably. This foundational knowledge informs the immediate life-saving actions necessary until professional help arrives.
Defining the Target Age Range
Emergency protocols distinguish between three pediatric groups based on physical development and size. The “child” category covers individuals from one year of age until the onset of puberty, which is identified by breast development in females or axillary hair in males.
This age range requires a specific assessment approach because their anatomy differs substantially from an infant (under one year old) or an adult. Infants, for example, require a pulse check at the brachial artery on the upper arm due to their short neck structure, while post-puberty individuals are treated as adults.
The Primary Pulse Check Location
The recommended site for checking a pulse in this age group is the carotid artery, located on the side of the neck. As a central artery, it is the most accessible and reliable location for a lay rescuer to detect blood flow. If a pulse is present anywhere in the body, it is most likely to be palpable here.
The carotid artery is preferred over peripheral locations, such as the radial artery in the wrist, due to blood flow dynamics. If a child is unconscious and potentially in shock, blood pressure may drop severely, making peripheral pulses too weak to feel. Since the carotid artery supplies blood directly from the heart to the brain, it will carry a detectable pulse even when circulation is significantly compromised.
The femoral artery, found in the crease between the inner thigh and the groin, is an alternative central location. Although reliable, it is often less convenient to access quickly than the carotid artery.
Proper Technique for Locating the Pulse
To check the carotid pulse, position the child on their back for clear access to the neck. The rescuer should use two or three fingers (index and middle), avoiding the thumb because it has its own strong pulse. Begin by locating the trachea (windpipe) at the center front of the neck.
Gently slide the fingers into the groove formed between the trachea and the large neck muscles on the side closest to the rescuer. Apply light pressure to feel for a pulsation under the fingertips. The pulse check must be performed quickly, taking a minimum of five seconds but no more than ten seconds, to minimize delay in starting compressions if needed.
If no pulse is clearly felt within this brief window, or if the rescuer is unsure, the protocol mandates proceeding as if no pulse is present. Avoid excessive pressure, as pressing too firmly can compress the artery and prevent the detection of a weak pulse.
Immediate Action Following Pulse Assessment
The action taken depends entirely on the assessment made within the ten-second window.
If a definite pulse is felt, the immediate next step is to activate the emergency response system (e.g., calling 911). If the child is not breathing or is only gasping, the rescuer must begin rescue breathing, giving one breath every three to five seconds.
If a pulse is present but the heart rate is less than 60 beats per minute, especially if the child shows signs of poor perfusion (like pale or bluish skin), the rescuer must immediately begin chest compressions. A heart rate below this threshold is inadequate to maintain life.
If no pulse is felt at all, or if the rescuer is unsure, there must be no delay in initiating Cardiopulmonary Resuscitation. The rescuer should immediately begin cycles of chest compressions and rescue breaths, starting with compressions. For a single rescuer, the ratio is thirty compressions followed by two breaths, continuing until emergency services arrive or the child shows signs of life.