CPR Certification Manual: Positioning & Pulse Check

Positioning & Pulse Check

Proper positioning helps make chest compressions effective. For most people in cardiac arrest, place the person on their back on a firm, flat surface whenever practical.

Rescuer Position

For adult and child CPR, kneel beside the person's chest. Position yourself so that your shoulders are directly over your hands during compressions. Keep your arms straight and use your upper body to compress the chest.

For infant CPR, position yourself beside the infant so the chest can be compressed while maintaining proper hand or thumb placement.

Pulse Checks

A pulse check is not required for a lay rescuer before beginning CPR. If a person is unresponsive and not breathing normally or is only gasping, begin CPR.

If you have been specifically trained to perform pulse checks and your professional role or response protocol calls for one, check for no more than 10 seconds. Do not delay CPR while trying to locate a pulse.

If you cannot definitely determine that a pulse is present within 10 seconds, begin chest compressions.

Pulse Locations for Trained Responders

When a pulse assessment is appropriate:

• Adults: Carotid pulse at the side of the neck
• Children: Carotid or femoral pulse
• Infants: Brachial pulse inside the upper arm or femoral pulse

These pulse checks are included for trained responders and are not required for routine lay-rescuer CPR.

Positioning Considerations

Move the person only as necessary to provide effective CPR or remove them from immediate danger. If possible, perform CPR on a firm surface. Do not unnecessarily delay compressions while attempting to achieve a perfect position.