Basic cardiac life support providers checking the carotid pulse: performance, degree of conviction, and influencing factors

Acad Emerg Med. 2004 Aug;11(8):878-80. doi: 10.1111/j.1553-2712.2004.tb00772.x.

Abstract

The American Heart Association recently abolished the carotid pulse check during cardiopulmonary resuscitation for lay rescuers, but not for health care providers.

Objectives: The aim of the study was to evaluate health care providers' performance, degree of conviction, and influencing factors in checking the carotid pulse.

Methods: Sixty-four health care providers were asked to check the carotid pulse for 10 or 30 seconds on a computerized mannequin simulating three levels of pulse strength (normal, weak, and absent). Health care providers were asked whether they felt a pulse and how certain were they that they felt a pulse. Performance was evaluated, as well as degree of conviction about the answer, using a visual analog scale. Data were compared by using a general linear model procedure.

Results: In the pulseless situations, the answers were correct in 58% and 50% when checking the pulse for 10 and 30 seconds, respectively. In the situation with a weak pulse, the answer was correct in 83% when checking the pulse for 10 seconds. In situations with a normal pulse, the answers were correct in 92%, 84%, and 84%, respectively, when checking the pulse for 10 (twice) and 30 seconds. The exactitude of the answer was correlated with the pulse strength (p < 0.05). The degree of conviction about the answer was correlated with the exactitude of the answer (p < 0.01) and the pulse strength (p < 0.0001).

Conclusions: These results question the routine use of the carotid pulse check during cardiopulmonary resuscitation, including for health care providers.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • American Heart Association
  • Attitude of Health Personnel
  • Carotid Arteries*
  • Clinical Competence
  • Emergency Treatment / methods*
  • Female
  • Humans
  • Life Support Care / methods*
  • Male
  • Manikins
  • Pulse / methods*
  • Task Performance and Analysis*
  • United States