Point-of-Care Ultrasound vs. Manual Palpation for Pulse Check in Cardiac Arrest Patients: A Systematic Review

Accurate pulse checks are extremely important in the management of cardiac arrest patients. Pulse check through manual palpation is known to be difficult and unreliable, even for health care providers. Given the increasing role of point-of-care ultrasound (POCUS) in cardiac arrest care, it may offer a more effective method for pulse check.

This systematic review aimed to investigate whether POCUS of the great arteries would be a more accurate and faster alternative to manual palpation for the pulse check during cardiac arrest.

We performed a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. A search was performed through Medline, Embase, Web of Science Core, Cochrane Central, and Google Scholar. The articles were screened for eligibility and assessed for risk of bias by two independent reviewers through the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) 2 tool.

The search yielded 437 articles, of which six matched our inclusion criteria. All three studies that reported about the accuracy had a higher accuracy for pulse check with POCUS. All five studies that reported about the speed of the pulse check had a shorter mean pulse check duration for POCUS.

This systematic review suggests that POCUS is quicker and more accurate than manual palpation for checking the pulse during cardiac arrest. However, the evidence is limited by the scarcity, variable quality, and the heterogeneity of the studies.