Comparison of femoral and carotid arteries in terms of pulse check in cardiopulmonary resuscitation: A prospective observational study

Resuscitation. 2021 May:162:56-62. doi: 10.1016/j.resuscitation.2021.01.042. Epub 2021 Feb 11.


Background: There is no gold standard pulse localisation for pulse check in cardiopulmonary resuscitation.

Aim: To compare the femoral and carotid arteries in terms of pulse check in cardiopulmonary resuscitation and recommend the most appropriate pulse localisation in advanced life support guidelines and cardiopulmonary resuscitation training programmes.

Materials and methods: We prospectively conducted the study with patients who developed non-traumatic cardiopulmonary arrest between September 2018 and March 2019. The pulse check team was established and divided into two groups, A and B. Both carotid and femoral arteries were checked simultaneously for pulse by members of groups A and B, with the groups alternating between sites to avoid bias. We used some criteria to make pulse detection more effective. These were ETCO2, rhythm and cardiac ultrasonography.

Results: We evaluated 1289 pulse checks in 102 patients. As a result of the statistical analysis with manual palpations and pulses criteria, which we used to detected the presence of a pulse in CPR, we found that the sensitivity of the carotid artery was significantly higher than that of the femoral artery (p = 0.017), with almost identical specificities.

Conclusion: The carotid artery should be recommended as the gold standard localisation for pulse checks in cardiopulmonary resuscitation in CPR training programmes and ACLS guidelines.

Keywords: Cardiopulmonary resuscitation; Carotid artery; Femoral artery; Pulse check.

Publication types

  • Observational Study

MeSH terms

  • Cardiopulmonary Resuscitation*
  • Carotid Arteries / diagnostic imaging
  • Femoral Artery / diagnostic imaging
  • Heart Arrest* / therapy
  • Humans
  • Pulse