The POCUS Pulse Check: A Case Series on a Novel Method for Determining the Presence of a Pulse Using Point-of-Care Ultrasound

J Emerg Med. 2019 Jun;56(6):674-679. doi: 10.1016/j.jemermed.2019.02.013. Epub 2019 Apr 16.


Background: During cardiopulmonary resuscitation, pulse checks must be rapid and accurate. Despite the importance placed on the detection of a pulse, several studies have shown that health care providers have poor accuracy for detection of central pulses by palpation. To date, the use of point-of-care ultrasound (POCUS) in cardiac arrest has focused on the presence of cardiac standstill and diagnosing reversible causes of the arrest.

Objective: This case series highlights a simple, novel approach to determine whether pulses are present or absent by using POCUS compression of the central arteries.

Discussion: Using this technique, we found that a POCUS pulse check can be consistently performed in < 5 s and is clearly determinate, even when palpation yields indeterminate results.

Conclusions: In this case series, the POCUS pulse check was a valuable adjunct that helped to change management for critically ill patients. Future prospective studies are required to determine the accuracy of this technique and the impact on patient outcomes in a larger cohort.

Keywords: cardiac arrest; pulse check; ultrasonography.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Point-of-Care Systems / standards*
  • Point-of-Care Systems / statistics & numerical data
  • Pulse / instrumentation*
  • Pulse / methods
  • Pulse / statistics & numerical data
  • Resuscitation / methods*
  • Time Factors
  • Ultrasonography / methods
  • Young Adult