Understanding how to check a pulse in infants and small children is a valuable skill for any caregiver. The pulse provides direct insight into a child’s heart rate, offering a basic assessment of their circulatory health. Monitoring a child’s pulse can help in recognizing changes in their well-being, whether due to activity, sleep, or illness. This technique allows caregivers to quickly gauge a child’s condition and determine if further medical attention is required.
Primary Pulse Points for Infants
For infants, typically up to one year of age, the most accessible and reliable pulse points are the brachial and femoral arteries. The brachial pulse is found on the inner arm, positioned between the elbow and the shoulder. To locate it, gently place two fingers, not your thumb, on the inside of the infant’s upper arm, near the middle. Press lightly until you feel a rhythmic beat. This site is preferred in infants because their necks are short and often chubby, making the carotid pulse difficult to find, and their radial pulse can be too faint.
The femoral pulse, located in the groin area, is another suitable option for infants. To check this pulse, lay the infant on their back and expose the groin area. Gently place two fingers in the crease between the infant’s leg and groin, applying light pressure. The femoral pulse can be particularly useful in emergency situations if the brachial pulse is difficult to locate.
Primary Pulse Points for Small Children
For small children, generally one year and older, the carotid and radial pulses become more prominent and easier to assess. The carotid pulse is located on the side of the neck, alongside the windpipe. To find it, gently place two fingers on one side of the child’s windpipe, pressing lightly until a beat is felt. It is important to avoid pressing on both sides of the neck simultaneously, as this can impede blood flow to the brain.
The radial pulse, located on the thumb side of the wrist, is also a common site for checking a pulse in older children. Position the child’s hand flat or slightly bent backward, then place two fingers at the base of their thumb and slide them down to the wrist. Apply gentle pressure to feel for the throbbing sensation.
Recognizing and Responding to Pulse Findings
After locating the pulse, observing its rate, rhythm, and strength provides valuable information about a child’s circulatory status. Normal resting pulse rates vary significantly with age:
Newborns (0-1 month): 70 to 190 beats per minute (bpm)
Infants (1-11 months): 80 to 160 bpm
Children (1-2 years): 80 to 130 bpm
Children (3-4 years): 80 to 120 bpm
Children (5-6 years): 75 to 115 bpm
These rates can fluctuate based on activity, sleep, excitement, or illness.
Assess the pulse’s rhythm (regular or irregular) and strength (strong or weak). A consistently high pulse (tachycardia) or a consistently low pulse (bradycardia) can indicate a health concern. A very fast pulse may suggest fever, pain, or dehydration, while a very slow pulse could indicate a more serious issue. An irregular pulse, though often harmless, can sometimes signal an underlying problem.
If a child’s pulse is absent, very weak, or significantly outside the normal range, immediate action is required. Check for a pulse for 5 to 10 seconds. If no pulse is detected, or if the heart rate is below 60 bpm with signs of poor perfusion (like pale or bluish skin), call emergency services immediately. If trained, initiating cardiopulmonary resuscitation (CPR) may be necessary, starting with chest compressions.