Check Your Baby's Pulse in a Heartbeat
Oct. 25, 2000 -- Ask a caregiver to check a baby's pulse and
the likely question will be "How?" A new study, published in
September's Journal of Pediatrics, has found one method superior to
others -- placing the ear over the left side of the baby's chest. However, some
experts assert that in an emergency, time should not be wasted on any
Some situations call for checking a baby's pulse at home, such
as when a doctors asks for a pulse reading over the phone or if the child is on
certain medications. It's also thought to be crucial to check for a pulse
before beginning CPR, and for parents of chronically ill infants, knowing CPR
is almost a necessity.
When Australian researchers compared the methods used to check
a baby's heartbeat, they found that 86% of 200 caregivers could correctly find
an infant's pulse by the ear-to-chest method. Unfortunately, just over half
could then report an accurate reading. But compared with the other methods
tested, this was a fabulous result.
Researchers found that many caregivers could also detect a
pulse along the upper arm, but again, fewer than half could get a proper
reading. Accuracy was about as bad for using the fingers to detect a chest
beat. And worst of all, testing the pulse by touching the neck produced
accurate results only 12% of the time.
The results don't surprise John Roquemore, a paramedic and
coordinator for the Emergency Medical Service in Jefferson Parish, La. "For
an infant, we tell parents to look for a pulse [along the upper arm]. But we
are having more and more problems having people find it -- especially if the
parent is new. Putting an ear to the baby's chest will give you a better idea
of a heartbeat -- especially in the case of an infant, because [the heartbeat
One problem with the whole concept of having parents -- or any
layperson -- check for a pulse is that it takes too long in an emergency.
Robert Berg, MD, director of pediatric critical care at the
University of Arizona in Tucson, puts it this way: "The most important
seconds of your life are ticking by with somebody saying [to themselves], 'Am I
hearing anything?'" It is for that general reason that the American Heart
Association (AHA) now recommends lay people not waste time checking for
a pulse. Rather, if someone looks dead or doesn't move, it's best to start
performing CPR. "The old approach, which seemed reasonable, flopped because
people couldn't find pulses well," says Berg. He adds that in some studies,
laypeople also found pulses when none existed.
Berg, chair of the AHA's Subcommittee on Pediatric
Resuscitation, says the Australian study was an excellent one -- and perhaps
could lead to other studies which might prove important to health care workers,
routinely taught to check for pulses using the arm method. For example, Janet
Crowers, RN, house supervisor at Children's Healthcare of Atlanta, Scottish
Rite, says, "Our health care organization uses the American Heart
Association guideline, which is checking for the pulse [at the arm]. That's
what we do as a standard. That's how we teach it."