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

Area of Science:

• Emergency Medicine
• Cardiology
• Clinical Performance Evaluation

Background:

• The American Heart Association removed the carotid pulse check for lay rescuers in cardiopulmonary resuscitation (CPR) guidelines.
• However, the guideline for health care providers still includes the carotid pulse check.
• The efficacy and accuracy of carotid pulse checks by health care providers remain under investigation.

Purpose of the Study:

• To assess the performance of health care providers in accurately checking the carotid pulse.
• To evaluate the degree of conviction health care providers have in their pulse checks.
• To identify factors influencing the performance and conviction in carotid pulse assessments.

Main Methods:

• Sixty-four health care providers participated in the study.
• Participants assessed carotid pulses on a computerized mannequin simulating normal, weak, and absent pulses.
• Pulse checks were performed for 10 or 30 seconds, followed by self-reported certainty of findings.

Main Results:

• Accuracy in detecting absent pulses was 58% (10s) and 50% (30s).
• Accuracy for weak pulses was 83% (10s), and for normal pulses ranged from 84% to 92%.
• Higher conviction correlated with more accurate pulse detection and stronger pulse simulation.

Conclusions:

• The study findings raise concerns about the routine use of carotid pulse checks during CPR for health care providers.
• The accuracy and reliability of this maneuver may not be sufficient for clinical decision-making in CPR.
• Re-evaluation of current CPR guidelines regarding the carotid pulse check for health care providers is warranted.