BLS Certification Manual: Positioning & Pulse Check

Positioning & Pulse Check

Correct positioning and a rapid pulse assessment help determine the appropriate BLS response.

Positioning

When CPR is required, position the person on their back on a firm, flat surface whenever practical. Kneel beside the chest so compressions can be delivered with proper body mechanics. Avoid unnecessary delays while repositioning the person.

Pulse Check

A trained BLS responder should assess for a pulse for no more than 10 seconds. If a definite pulse cannot be detected within 10 seconds, begin chest compressions. When checking the carotid pulse, use 2-3 fingers placed gently on the side of the neck — avoid using the thumb, which has its own pulse and can lead to an inaccurate reading.

Adult

Check the carotid pulse.

Child

Check the carotid or femoral pulse.

Infant

Check the brachial or femoral pulse.

Pulse Present but Breathing Inadequate

If the person has a definite pulse but is not breathing normally, provide rescue breathing.

For an adult:

• Give 1 breath every 6 seconds
• Recheck the pulse approximately every 2 minutes

For an infant or child:

• Give 1 breath every 2-3 seconds
• Reassess the pulse and condition approximately every 2 minutes

Pediatric Heart Rate Below 60

For an infant or child with a pulse less than 60 beats per minute with signs of poor perfusion despite adequate oxygenation and ventilation, begin chest compressions.

Do Not Delay CPR

If there is uncertainty about whether a pulse is present, begin chest compressions rather than prolonging the assessment.