The Carotid Pulse is the first pulse you should feel for in an unconscious adult or older child as it can be felt even when the patient has dangerously low blood pressure.
When palpating the carotid pulse, you are feeling for the common carotid artery that sits in a groove between the trachea and the neck muscles and is backed by the anterior surface of the cervical vertebrae. To palpate a carotid pulse:
- Place the tips of two to three fingers, (usually your index, middle, and ring finger if you use three) in the center of the throat over the trachea.
- Slide your fingers towards yourself into the groove between the trachea and the neck muscles.
- Press your fingers gently into the groove.
- You may need to adjust the position of your fingers slightly up or down to find the pulse. Avoid moving into the upper third of the neck, as you could press on the carotid sinus which may lead to vagal stimulation/slowing the heart rate, particularly in older adults.
Do not press too firmly, as you may cut off blood flow to the brain if the patient does not have good bilateral blood supply.