Cardiopulmonary Resuscitation (CPR) is a life-saving technique used in emergencies when someone’s breathing or heart has stopped. Immediate action is important in cases of cardiac arrest, as prompt and correct assessment can significantly improve outcomes.
The Carotid Artery: Primary Pulse Check Site
In an emergency, the carotid artery in the neck is the most reliable location to check for a pulse. This artery is large and positioned close to the heart, which means its pulse can often be felt even when other peripheral pulses, such as those in the wrist, are faint or absent. Its accessibility also makes it suitable for quick assessment.
To locate the carotid pulse, find the trachea in the middle of the neck. Gently slide your index and middle fingers into the groove located beside the windpipe, between it and the large muscle running from behind the ear to the collarbone. Apply gentle pressure with your fingertips to feel for the pulsation.
It is important to use only two or three fingers and avoid pressing too hard, as excessive pressure can obstruct blood flow or slow the heart rate. Never check both carotid arteries at the same time, as this can compromise blood flow to the brain. While other pulse points exist, such as the radial artery in the wrist, they are not typically recommended for a rapid emergency assessment due to being less reliable in situations of reduced blood flow.
Pulse Checks and Lay Rescuer CPR
For a lay rescuer, current guidelines for an unresponsive adult emphasize checking for normal breathing rather than a pulse. If an adult is unresponsive and not breathing normally—perhaps only gasping or showing no breathing at all—chest compressions should be initiated immediately.
If a pulse check is performed, it must be completed quickly. The assessment should take no more than 10 seconds. Exceeding this time limit can delay the start of chest compressions, which is important for maintaining blood flow to the brain and other organs.
If no definite pulse is felt within those 10 seconds, or if the person remains unresponsive and is not breathing normally, chest compressions should be started or continued without hesitation. Before or while beginning CPR, it is important to call emergency services, such as 911 in the United States, to ensure professional medical help is on the way. The modern approach for lay rescuers stresses immediate chest compressions over time-consuming pulse checks to maximize the chances of a positive outcome.