Pulse checks are important in assessing heart rate and overall circulatory status. They help guide further medical interventions. Healthcare professionals and caregivers should learn the preferred method for pulse checks in infants. When it comes to providing care for infants in emergency situations, knowing the correct procedures to check an infant’s pulse accurately can make a significant difference. In this blog, we provide a comprehensive guide to performing a pulse check in infants.
Why Pulse Checking is Important in Infants
In critically ill or injured infants, quick assessment and timely actions are crucial for improved outcome. Pulse checks help evaluate the heart’s pumping ability and can give vital signs of cardiac arrest or other serious conditions. This information is essential for guiding resuscitation and other emergency medical responses. Pulse checking in an infant is vital for so many reasons. Some of the importance of pulse reading are as follows:
1. Early detection of critical emergencies: Pulse checks help healthcare providers quickly identify cardiac issues like bradycardia, tachycardia, or cardiac arrest, allowing for immediate intervention to improve survival chances.
2. Monitoring circulation and oxygenation: Pulse checks provide information about an infant’s circulatory status and ensure the heart is effectively delivering oxygen-rich blood to essential organs. This helps identify issues like shock or poor perfusion, allowing timely intervention to support survival and well-being.
3. Guiding resuscitation efforts: Pulse checks help assess the effectiveness of interventions like Cardiopulmonary Resuscitation(CPR) during emergencies. Changes in pulse rate or quality indicate how the infant is responding, guiding further resuscitation and treatment decisions.
Also Read: Proper Procedure for Delivering Rescue Breaths to an 8-year-Old Child
4. Differentiating between respiratory and cardiac causes: In emergencies, pulse checks help distinguish between respiratory arrest (where a pulse is still present) and cardiac arrest (where no pulse is detected), which require different management approaches.
5. Establishing a clinical baseline: Regular pulse checks provide a reference point for evaluating changes in an infant’s condition over time, helping healthcare providers recognize deterioration or improvement more accurately.
The Preferred Method for Checking Pulse in Infants: Brachial Pulse Check
The brachial pulse is the preferred method for checking the pulse in an infant. The location of the brachial artery in an infant is on the inside of the upper arm, between the elbow and the shoulder. This method is particularly useful in newborn babies, as other pulse points can be difficult to locate and may not give as clear a reading. Proper technique is essential to ensure accurate assessment and to avoid any discomfort to the infant.
Here’s a step-by-step guide to performing a brachial pulse check:
Step 1: Position the Infant
You need to lay the infant on its back on a firm, flat surface, such as a changing table or examination bed. Ensure that the infant is calm and still to get an accurate pulse reading easily.
Step 2: Locate the Brachial Artery
Then, extend the infant’s arm straight out along the side, ensuring it is relaxed. Using your index and middle fingers, gently feel the inside of the upper arm between the elbow and shoulder. This is where the brachial artery is located.
Step 3: Apply Gentle Pressure
Once you have located the area where the brachial artery is felt most strongly, apply gentle pressure using your index and middle fingers. Avoid using your thumb, as it has its own pulse that can interfere with correct pulse reading. Be careful not to press too hard, as excessive pressure may block the artery and make it more difficult to detect the pulse.
Step 4: Assess the Pulse
Now, feel for the pulsations of the brachial artery beneath your fingertips. If the artery is easy to find, you should feel a rhythmic pulsing. Pay attention to the strength and regularity of the pulse.
Step 5: Count the Beats
While maintaining pressure on the artery, count the number of beats you feel over 15 or 30 seconds. Multiply the number of beats in 15 seconds by four or 30 seconds by 2 to calculate the infant’s heart rate in beats per minute (bpm).
Step 6: Note the Findings
Be sure to record observations such as changes in pulse strength, heart rate, and rhythm patterns. You can compare the infant’s heart rate with normal age-specific ranges to help determine if the infant’s pulse is healthy.
Step 7: Repeat if Necessary
If you are unsure of your initial findings or need to confirm the pulse rate, repeat the process on the opposite upper arm or at the same site.
Note: Immediately stop and begin cardiopulmonary resuscitation(CPR) if no pulse is felt within 10 seconds, or the pulse is less than 60 beats per minute with signs of poor perfusion.
Why is the Brachial Pulse checked in infants?
Brachial Pulse is a preferred pulse check for infants due to its reliability and speed in various medical situations. This method is preferred in infants for several reasons:
Accessibility
The brachial artery is easily accessible in a newborn baby. It is located on the inside of the upper arm between the elbow and shoulder. This makes it easy to locate and feel, even in emergencies.
Reliability
The pulse in the brachial artery of a baby is typically strong and detectable, providing a reliable measure of the infant’s heart rate. This reliability is crucial in emergencies where quick and accurate assessment is needed.
Minimal Obstruction
There is less muscle and fat tissue overlying the brachial artery in infants compared to other pulse sites. So the obstruction is minimum and it is easier to feel and assess the pulse. This clear access is especially important in high-pressure situations.
Standardization in Training
Using the brachial pulse for infant pulse checks is a standardized method taught in CPR and PALS courses. This consistency in training ensures that healthcare providers and rescuers are proficient in a universally accepted technique. It enhances the effectiveness of resuscitation efforts.
Alternative Sites
While the brachial pulse is the preferred site for checking pulses in infants, there are alternative locations also where you can check a pulse if necessary:
Femoral Pulse: The Femoral pulse is felt in the femoral artery, and this artery is located in the groin area, where the thigh meets the pelvis. This site is also reliable, but can be more challenging to access quickly.
Apical Pulse: This involves listening to the heart with a stethoscope placed on the chest, directly over the heart. It is less commonly used in emergency settings due to the need for a stethoscope and the time it takes to accurately assess.
Tips for Accurate Pulse Checking
When it comes to performing CPR on infants, checking the pulse accurately is a critical step. In high-pressure situations where every second counts, the ability to quickly and correctly assess the infant’s pulse can significantly impact the effectiveness of your resuscitation efforts and overall patient outcomes. Here are some essential tips to ensure you perform pulse checks accurately:
Stay Calm: You need to stay calm in such emergencies. Staying calm will help you perform the pulse check more accurately.
Practice: You need to regularly practice locating and palpating the brachial pulse on healthy infants to build confidence and proficiency.
Use Proper Technique: Be sure of the techniques you are using. Make sure you use the pads of your index and middle fingers, and avoid using your thumb.
When to Seek Medical Help?
It is important to know when to seek medical help for your baby for their health and safety. Early knowledge about warning signs can help ensure prompt treatment. Here are five key points to guide you:
1. Abnormal Heart Rate: Contact a doctor or visit the emergency room if your baby’s heartbeat is consistently too fast, too slow, or irregular for their age, as this could indicate issues like fever, pain, dehydration, or a serious condition.
2. Breathing Difficulties: Seek immediate medical attention if your baby has trouble breathing, is breathing too fast or too slow, or is gasping for air, as these are signs of potential distress.
3. Skin Discoloration: Get urgent help if your baby’s skin looks pale, bluish, or gray, particularly around the lips, fingers, or face, as this may suggest they are not getting enough oxygen.
4. Lethargy or Unresponsiveness: Call a doctor right away if your baby is excessively sleepy, unresponsive to touch or sound, or appears very weak or floppy, as these could indicate a serious problem.
5. No Pulse or Unresponsive: If you cannot find a pulse and your baby is unresponsive or not breathing, start CPR immediately and call emergency services without delay.
Conclusion
Practical knowledge on checking an infant’s pulse accurately is critical for healthcare providers and caregivers. The brachial pulse is the preferred method for pulse checking in an infant due to its accessibility and reliability. By using this technique, you can ensure prompt and accurate assessments that are vital in emergency care. Whether you are a healthcare provider working in an emergency pediatric care or a new parent, understanding and practicing the correct method for pulse checking in infants is an invaluable skill that can make a significant difference in critical moments.
If you wish you gain skills on checking pulse in infants and managing pediatric emergencies then, join comprehensive training in PALS at Heart Start CPR in the San Francisco Bay Area. With expert instructors and state-of-the-art training facilities, you will gain the knowledge to perform high-quality CPR and advanced pediatric life support, enhancing your ability to save lives.
