Femoral venous pulsations during open-chest cardiac massage

We describe the cases of two children with easily palpated femoral pulses during open-chest cardiac massage after aortic occlusion. These pulsations must have arisen from the femoral veins, implying that during CPR in children the usual anatomic landmarks for femoral venous access may be unreliable, and femoral pulsations do not necessarily reflect arterial flow. Femoral pulses may signify to-and-fro inferior vena caval flow that compromises venous return, adversely affecting cardiac output and the effectiveness of medication administration to the lower extremity.