Are You Still Feeling For A Pulse? Stop It!

Subscribe to Resus

Get the latest updates on our Conferences PLUS our Webcasts and Education Newsletters. And it's FREE!

  • We respect your privacy
  • This field is for validation purposes and should be left unchanged.

Register Now:

Sorry, we couldn't find any posts. Please try a different search.

I remember years ago when we used to manage cardiac arrests and everyone was asked to stop compressions while someone felt for a pulse. Do you remember that? “I think I feel one. I wonder if that’s mine? Can someone else feel please?” Meanwhile time with no CPR passed.

Today with the push for cardiocerebral resuscitation and the importance of continuous CPR, foremost in our minds, we do everything we can to avoid delays in CPR.

When we do feel for a pulse in that few seconds of break in CPR, whilst breaths are being given, how good are we at getting it right? Are we wasting our time? Are we making mistakes that can cause mortality?

The FEEL Study(1) in 2010, a prospective trial,  where 204 patients underwent a ‘FEEL’ ultrasound examination during ongoing cardiac arrest (100) and in a shock state (104). The results are surprising:

  • 35% of those with an ECG diagnosis of asystole, and
  • 58% of those with PEA,

had coordinated cardiac motion detected on ultrasound, and was associated with an increased rate of survival. This is huge!

The REASON Trial in 2016, a non-randomised prospective trial run at 20 hospitals, looked at cardiac ultrasound performance in cardiac arrest.

793 patients were enrolled in this study. 54% of patients diagnosed with PEA had cardiac activity on initial bedside cardiac echo.

The results are very similar.

I would expect it to be even more difficult in children. In a 2009 paper in Resuscitation (3), where all cardiovascular information was obscured,  doctors and nurses were asked to assess if there was a pulse or not in 16 infants. The results were not good.  External cardiac compressions were withheld on 14% of occasions when they were needed and in 36% of cases were given when they were not needed.

The moral to the tale is in PEA especially we need to use the bedside echo to determine if there is any cardiac wall motion. Cardiac wall motion is what we are looking for, not valve motion which can occur when giving intravenous fluids and ventilating the patient. More on this next time and at our Echocardiogram workshops.


  1. Raoul Breitkreutz, et al. Focused echocardiographic evaluation in life support and peri-resuscitation of emergency patients: A prospective trial. November 2010Volume 81, Issue 11, Pages 1527–1533
  2. Gaspari R et al. Emergency Department, Point of Care Ultrasound in Out of Hospital and  in ED Cardiac Arrest. Resuscitation 2016;September 28.
  3. Tibballs J1, Russell P. Reliability of pulse palpation by healthcare personnel to diagnose paediatric cardiac arrest. Resuscitation. 2009 Jan;80(1):61-4.


Associate Professor Peter Kas

Posted in ,

Dr Peter Kas

Emergency Physician, Educator. Key Interests: Resuscitation, Airway, Emergency Cardiology, Clinical Examination. Creator


  1. charles makray on 26/09/2019 at 8:30 am

    would love to subscribe thank you

  2. Consuelo on 06/10/2021 at 11:43 pm

    I like it when folks come together and share thoughts. Great site, stick with it!

  3. Sienna on 14/10/2021 at 12:20 pm

    Link exchange is nothing else however it is simply placing the other person’s blog link on your page at proper place and other
    person will also do similar in favor of you.

  4. on 14/10/2021 at 12:26 pm

    Keep functioning ,remarkable job!

    my site … (

  5. on 14/10/2021 at 4:25 pm

    I have read a few good stuff here. Definitely value bookmarking for revisiting.
    I surprise how so much attempt you put to make this sort
    of great informative site.

    My blog post;–31820600 (

  6. on 14/10/2021 at 5:25 pm
  7. Rudolf on 14/10/2021 at 5:48 pm

    After looking over a handful of the articles on your web page, I seriously appreciate your
    way of blogging. I saved it to my bookmark website list and will be checking back in the near future.
    Please check out my website as well and let me know your opinion.

    Also visit my web-site – (Rudolf)

  8. Ellis on 14/10/2021 at 9:13 pm

    Very interesting details you have noted, thank you for

    my web site – [Ellis]

  9. on 14/10/2021 at 9:14 pm

    Greetings! Very useful advice in this particular article!
    It’s the little changes that produce the most important changes.
    Thanks for sharing!

    Also visit my web page – (

  10. Kellye on 14/10/2021 at 9:30 pm

    After going over a few of the blog articles on your site, I really appreciate your
    technique of blogging. I added it to my bookmark site list and will be checking back soon. Take a look at my web
    site too and let me know how you feel.

    my page:, Kellye,

  11. on 14/10/2021 at 9:33 pm

    hi!,I really like your writing very much! share we keep up
    a correspondence extra approximately your article on AOL?
    I need a specialist in this house to solve my problem. May be that’s you!
    Looking ahead to see you.

    Also visit my website :: (

  12. on 14/10/2021 at 10:25 pm

    Greetings! Very helpful advice in this particular article!

    It is the little changes that make the most important changes.

    Many thanks for sharing!

    My blog post – []

  13. on 14/10/2021 at 11:58 pm

    No matter if some one searches for his essential thing, so he/she wants to be available that in detail,
    so that thing is maintained over here.

    My web blog ::

  14. on 15/10/2021 at 12:50 am

    Hey! This is my first visit to your blog! We are a group of
    volunteers and starting a new project in a community
    in the same niche. Your blog provided us beneficial information to work on. You have done a outstanding job!

    Feel free to visit my web blog: (

  15. Latoya on 15/10/2021 at 12:52 am

    Hey there, You have done an excellent job. I’ll certainly digg it and in my view suggest
    to my friends. I’m confident they will be benefited from this site.

    My site–31821496 (Latoya)

  16. Salvador on 15/10/2021 at 12:53 am

    Hi there, You’ve done an excellent job. I will
    definitely digg it and in my view recommend to my friends.
    I’m confident they will be benefited from this website.

    Feel free to visit my web blog …,

  17. Maurice on 15/10/2021 at 1:14 am

    Aw, this was an extremely nice post. Spending some time and actual effort to generate a great article…
    but what can I say… I procrastinate a lot and don’t seem to get nearly anything done.

    Also visit my web site :: (Maurice)

Leave a Comment