The pulse check has been an important part of the assessment of unresponsive patients. It may be the determining factor in making the decision to commence CPR. We know that pulse checks are associated with both false positives and false negatives. False negatives can result in potentially unnecessary CPR being performed and false positives, can result in CPR being withheld… potentially disastrous. It is for this reason that we don’t do pulse checks now, but commence CPR in the unresponsive patient.
There are some situations when knowing if there is a pulse, or cardiac output is important. The pulse determines the difference between PEA and a shocked state.
In this paediatric study of patients undergoing cardiopulmonary bypass, they looked at performance of candidates in detecting a pulse. There was a false positive rate of 24%. That means that CPR may have been withheld in these cases.
Lets look at a study determining accurate of pulse detection.
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