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J Emerg Med. 2019 Apr 16. pii: S0736-4679(19)30100-3. doi: 10.1016/j.jemermed.2019.02.013. [Epub ahead of print]

The POCUS Pulse Check: A Case Series on a Novel Method for Determining the Presence of a Pulse Using Point-of-Care Ultrasound.

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Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada.
Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada.
University of Toronto, Toronto, Ontario, Canada.



During cardiopulmonary resuscitation, pulse checks must be rapid and accurate. Despite the importance placed on the detection of a pulse, several studies have shown that health care providers have poor accuracy for detection of central pulses by palpation. To date, the use of point-of-care ultrasound (POCUS) in cardiac arrest has focused on the presence of cardiac standstill and diagnosing reversible causes of the arrest.


This case series highlights a simple, novel approach to determine whether pulses are present or absent by using POCUS compression of the central arteries.


Using this technique, we found that a POCUS pulse check can be consistently performed in < 5 s and is clearly determinate, even when palpation yields indeterminate results.


In this case series, the POCUS pulse check was a valuable adjunct that helped to change management for critically ill patients. Future prospective studies are required to determine the accuracy of this technique and the impact on patient outcomes in a larger cohort.


cardiac arrest; pulse check; ultrasonography

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