One of the biggest indicators that someone is in need of CPR is if they have no pulse, as this signifies that the heart is no longer pumping blood throughout their body.
Without oxygenated blood circulating, the brain and body will die.
But, should rescuers be checking for a pulse during CPR? What if the heart starts beating again? Could the decision to stop CPR to check for a pulse, even for a moment, impact a patient’s chance of survival?
Let’s discuss the Do’s and Don’ts of checking for a pulse during CPR.
We are starting with the Don’ts because, first and foremost, the most important point to remember is this:
DON’T stop giving chest compressions to check for a pulse.
Because every second that there is an interruption in chest compressions decreases the patient’s chance of survival.
Checking for a pulse is important, but it should not take priority over giving chest compressions. Stopping chest compressions to check for a pulse may compromise the chance to save the person’s life.
In fact, some professionals state that pulse checks should be avoided altogether. For example, the Sarver Heart Center at The University of Arizona doesn’t even recommend that public rescuers waste time trying to assess for a palpable pulse, as they cannot reliably detect the absence of a pulse in a timely fashion. The American Heart Association had the same findings, resulting in them removing the pulse check requirement from their CPR Guidelines.
They also share that the correct response to a WITNESSED cardiac arrest is to:
- Check for responsiveness (shake and shout)
- If there is no response, call 911 or ask someone else to call
- Begin uninterrupted, forceful, and continuous chest compressions immediately
- Call for an AED if one is nearby and available
Check for a Pulse Before CPR in an UNWITNESSED Cardiac Arrest
Assessing signs of cardiac arrest in someone who is unresponsive should be done quickly so as not to delay lifesaving CPR intervention.
This means that you’ll want to check the carotid pulse for a minimum of 5 seconds, but no more than 10 seconds, to determine if there is a pulse present.
How to Check the Carotid Pulse
In order to check the carotid pulse, you first have to locate the carotid artery, which runs along both sides of the neck between the sternocleidomastoid (muscle on the side of the neck) and the trachea (windpipe).
- Place your index and middle fingers on the side of the neck closest to the rescuer
- Press gently
- Simultaneously watch for signs of breathing
If there is no pulse, administer CPR immediately.
If there is a pulse but the patient is breathing abnormally, begin rescue breathing (one breath every 5-6 seconds, not exceeding 10-12 breaths per minute).
***If you are not sure if the patient has a pulse or not, follow the “Better safe than sorry” approach and assume they don’t. The chances of damaging a beating heart with unnecessary chest compressions is very slim, but withholding chest compressions on someone in cardiac arrest will result in death.
Listen to AED Directions
AEDs detect heart rhythms and are designed to identify and respond to rapid or irregular heart rhythms by administering a shock.
They do not detect pulses.
AEDs provide rescuers with verbal directions and sometimes, an AED will tell you not to shock a patient. If this direction is received, the patient should be checked for a pulse. If no pulse is detected, continue to administer CPR and follow the directions given by the AED.
If you’ve ever wondered why CPR and AEDs should be used together to save a life, check out our blog, AED & CPR: Would You Ever Use One Without the Other?
Understanding the Do’s and Don’ts of checking for a pulse during CPR helps to ensure that a sudden cardiac arrest patient is given the best possible chance for survival.
And don’t forget – as important as it is to begin CPR immediately, it’s also equally important that 911 gets called so that emergency medical services as soon as possible.