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A new method of pulse control in cardiopulmonary resuscitation; Continuous femoral pulse check
E Sonmez1, B Taslidere2, A Ozkan3
1Kütahya Health Sciences University, Medical School, Department of Emergency Medicine, Kütahya, Turkey.
Insights
Continuous femoral pulse checks (CoFe PuC) significantly shorten cardiopulmonary resuscitation (CPR) interruption times compared to traditional carotid pulse checks (CPC). CoFe PuC offers earlier and more effective pulse assessment, suggesting its adoption in CPR guidelines.
Area of Science:
- Emergency Medicine
- Cardiology
- Critical Care
Background:
- Manual pulse checks are recommended in cardiopulmonary resuscitation (CPR) guidelines despite questioned reliability.
- Current CPR protocols often involve lengthy pulse check interruptions.
Purpose of the Study:
- To compare the 10-second carotid pulse check (CPC) with the continuous femoral pulse check (CoFe PuC) in CPR.
- To identify an optimal pulse check location to reduce interruption duration.
Main Methods:
- A prospective study involving 117 non-traumatic CPR patients.
- Simultaneous assessment of carotid and femoral pulses (702 measurements).
- Pulse validation using cardiac ultrasound, end-tidal CO2, saturation, respiration, and blood pressure.
Main Results:
- CoFe PuC decision time (3.03 ± 1.26 s) was significantly shorter than CPC (10.31 ± 5.24 s).
- CoFe PuC showed 74% sensitivity and 88% specificity for pulse absence.
- CPC showed 91% sensitivity and 61% specificity for pulse absence.
Conclusions:
- CoFe PuC provides earlier and more effective pulse information than CPC.
- CoFe PuC effectively shortens crucial interruption times during CPR.
- CoFe PuC is proposed as a valuable new method for CPR guidelines.
Objectives:
The reliability of manual pulse checks has been questioned but is still recommended in cardiopulmonary resuscitation (CPR) guidelines. The aim is to compare the 10-s carotid pulse check (CPC) between heart massage cycles with the continuous femoral pulse check (CoFe PuC) in CPR, and to propose a better location to shorten the interruption times for pulse check.
Methods:
A prospective study was conducted on 117 Non-traumatic CPR patients between January 2020 and January 2022. A total of 702 dependent pulse measurements were executed, where carotid and femoral pulses were simultaneously assessed. Cardiac ultrasound, end-tidal CO2, saturation, respiration, and blood pressure were employed for pulse validation.
Results:
The decision time for determining the presence of a pulse in the last cycle of CPR was 3.03 ± 1.26 s for CoFe PuC, significantly shorter than the 10.31 ± 5.24 s for CPC. CoFe PuC predicted the absence of pulse with 74% sensitivity and 88% specificity, while CPC predicted the absence of pulse with 91% sensitivity and 61% specificity.
Conclusion:
CoFe PuC provides much earlier and more effective information about the pulse than CPC. This shortens the interruption times in CPR. CoFe PuC should be recommended as a new and useful method in CPR guidelines.
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