Skills of lay people in checking the carotid pulse

Abstract

American Heart Association as well as European Resuscitation Council require the carotid pulse check to determine pulselessness in an unconscious victim and to decide whether or not cardiopulmonary resuscitation (CPR) should be initiated. Recent studies on the ability of health professionals to check the carotid pulse have called this diagnostic tool in question and led to discussions. To contribute to this discussion we performed a study to evaluate skills of lay people in checking the carotid pulse. A group of 449 volunteers (most had participated in a first aid course) were asked to check the carotid pulse in a young healthy, non-obese person by counting aloud the detected pulse rate. Time intervals until correct detection of the carotid pulse were registered. Overall the volunteers needed an average of 9.46 s, ranging from 1 to 70 s. Only 47.4% of the volunteers were able to detect a pulse within 5 s, and 73.7% within 10 s. A level of 95% volunteers detecting the pulse correctly was reached only after 35 s. Based on these findings we conclude that the intervals established for carotid pulse check may be too short and that perhaps the value of pulse check within in the scope of CPR needs to be reconsidered.