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 emergencies, knowing the correct procedures to check an infant’s pulse accurately can make a significant difference.
This blog explains a detailed, step-by-step guide to help caregivers and healthcare providers accurately perform pulse checks in infants, ensuring safe and effective assessment in emergencies.
Why Is Pulse Checking Important in Infants?
In critically ill or injured infants, quick assessment and timely actions are crucial for improved outcomes. 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.
How Do You Check an Infant’s Pulse Using the Brachial Method?
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:
1. 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 the shoulder. This makes it easy to locate and feel, even in emergencies.
2. 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 a quick and accurate assessment is needed.
3. 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.
4. 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.
What Are the Alternative Sites for Checking an Infant’s Pulse?
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:
1. 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.
2. 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.
What Are Some 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:
1. Stay Calm
You need to stay calm in such emergencies. Staying calm will help you perform the pulse check more accurately.
2. Practice Regularly
You need to regularly practice locating and palpating the brachial pulse on healthy infants to build confidence and proficiency.
3. 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.
4. Ensure Proper Positioning
Position the infant flat on a firm surface with the arm relaxed; correct positioning improves pulse detection and reduces stress for both the rescuer and the infant.
5. Check for Consistency
Observe the pulse for at least 5-10 seconds to confirm rate and rhythm. Consistency helps differentiate between a true pulse and irregular or weak beats.
What Are the Common Mistakes To Avoid While Checking Pulse In An Infant?
Checking an infant’s pulse can be tricky, and even small mistakes can affect accuracy. Here, we highlight common errors to avoid so you can assess confidently and keep your baby safe.
Common mistakes to avoid when checking an infant’s pulse include:
- Using the Thumb Instead Of Fingers
Your thumb has its own pulse, which can confuse you while checking the baby’s heartbeat. Always use your index and middle fingers to feel for the pulse. - Applying Too Much Pressure
Pressing too hard can block the artery, making it difficult or impossible to feel the pulse. Use gentle, steady pressure, especially since an infant’s arteries are small and delicate. - Choosing The Wrong Pulse Location
The brachial artery (Inside the upper arm) is the recommended location for infants. Trying to check the carotid (Neck) pulse can be difficult and may cause discomfort or airway obstruction. - Checking For Too Long a Time
During an emergency, do not spend more than 10 seconds trying to locate a pulse. If you cannot detect one quickly, immediately begin CPR to maximize the infant’s chance of survival. - Panicking During The Assessment
Stress can lead to rushed or incorrect technique. Stay calm and focused so you can accurately assess the pulse and other signs of distress. - Ignoring Other Warning Signs
A pulse check should not be done alone. Always observe breathing, skin color, responsiveness, and overall behavior. These signs together give a clearer picture of the infant’s condition. - Failing To Seek Help When Needed
If you cannot find a pulse within 10 seconds and the infant is unresponsive or not breathing normally, begin CPR immediately and call emergency services without delay.
Avoiding these common mistakes helps ensure a more accurate pulse assessment and better protection of your infant’s health and safety.
When Should You 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.
Master Infant Pulse Checks to Save Lives
Practical knowledge of 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. 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 setting 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 to gain skills in 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.
FAQs About Checking an Infant’s Pulse
1. What is a Normal Heart Rate Range For an Infant?
For infants from birth up to 12 months, a normal resting heart rate usually falls between 100 and 160 beats per minute. Keep in mind that it can be higher if the baby is crying, active, or not feeling well, so a little variation is totally normal.
2. How Long Should You Check an infant’s Pulse During an Emergency?
In an emergency, you should check an infant’s pulse for no more than 10 seconds. If you do not feel a pulse within that time, start CPR right away. Waiting longer can waste precious time, so it is important to act quickly.
3. Can You Use a Pulse Oximeter Instead of Manually Checking the Pulse?
A pulse oximeter can be useful for measuring a baby’s oxygen levels and heart rate, but in an emergency, manually checking the pulse is faster and more reliable. Quick hands-on assessment allows you to make immediate decisions, which can be critical for the infant’s safety.
4. Why Should You Avoid Using Your Thumb When Checking a Pulse?
You should avoid using your thumb because it has its own pulse. This can make it harder to tell the infant’s actual pulse and may lead to inaccurate readings. It is better to use your index and middle fingers to feel the pulse carefully and reliably.
5. What Should You Do if You Feel a Weak Pulse in an Infant?
If the infant has a weak pulse and shows signs like pale skin, weak breathing, or unresponsiveness, call emergency services and start CPR if the heart rate is below 60 beats per minute.
