When an infant stops breathing, panic can take over fast. Knowing what to do during the first minute or within 10 seconds is critical. One of the biggest mistakes people make during CPR is the pulse check in an infant at the wrong spot.
It’s easy to assume you should check the neck or wrist like you would for an adult, but that doesn’t work the same for babies.
In fact, the American Heart Association says most people lose time by looking in the wrong place. That delay can cost a life.
What is the Preferred Method for Pulse Check in an Infant?
As a healthcare student and someone who has gone through infant CPR training, I quickly learned that the preferred method for checking infant pulse is through the brachial artery, using 3 fingers on the inside for accuracy.
I didn’t know that at first. I assumed you could use the neck like in adults. But it’s not the same. Infants have smaller bodies and thinner arteries, and the neck isn't easy or safe to feel the pulse on a baby.
The brachial pulse is not only easier to locate but also gives a reliable reading when time matters most. Let me break this down step-by-step so it’s simple and useful for anyone who needs it.
How Rescuers Check Pulse in an Infant?
In training, I watched experienced paramedics check an infant’s pulse using just two fingers on the inside of the upper arm. They didn’t go near the wrist or neck, as the pulse is less detectable there. They always used the upper arm, especially during emergencies like cardiac arrest in newborn.
They explained this is the safest and fastest method. You have to be calm and precise. It made a big difference once I got the hang of it. They also showed how not to press too hard. Gentle pressure is key, especially when checking the pulse rate in infants.
Brachial Pulse Location in Infants
The brachial pulse is located on the inside of the infant’s upper arm, between the elbow and the shoulder. You’ll want to feel for it on the inside of the arm, near the middle. Use the flat pads of your index and middle fingers, never the thumb.
Because the 2 thumb-encircling has its own pulse, and it can confuse your reading. You place 2 or 3 fingers along the inner bicep area and press gently.
It takes practice to find it quickly, but once you know the spot, it’s easy to return to it. I practiced on infant manikins until it felt natural.
Best Way to Check Pulse During Infant CPR
As rescuer begin CPR, things get intense. You only have seconds to act. The best way to check the pulse during infant CPR is using the brachial artery while keeping the infant’s arm straight at the side.
I learned to do this while my partner started compressions. Timing and teamwork are necessary for effective cardiopulmonary resuscitation, especially when checking pulse rates and coordinating efforts. The goal is to check for a pulse quickly, ideally in less than 10 seconds.
If you're alone, you check right before starting compressions and then every 2 minutes during cardiopulmonary resuscitation cycles.
Using Brachial Pulse in CPR
The brachial pulse works well during CPR because it’s central, clear, and doesn’t get interrupted by chest compressions like other pulse points might.
When starting with chest compressions, blood flow changes fast. The brachial site stays stable and easy to monitor.
I remember my first real training session where I had to check the pulse while another person did compressions. I was nervous, but I found the brachial point quickly and realized how reliable it was.
Why Brachial Pulse Is Used in Infants?
The reason we use the brachial point in infants is mostly about access and reliability. The neck is hard to access in infants. The femoral pulse artery is deeper and less practical when the baby is clothed.
A baby's brachial pulse is easy to find and less likely to be missed. This artery runs close to the skin and is not surrounded by as much fat or muscle. That makes it perfect for quick and accurate pulse checks in babies under one year old, ensuring the depth of the chest compressions is appropriate.
How to Find the Brachial Pulse in Newborns?
Here’s the step-by-step method that I follow: First, lay the baby on a firm flat surface. Extend one of their arms slightly out to the side.
Place the pads of your index and middle fingers on the inside of the upper arm, midway between the elbow and shoulder. Press lightly until you feel a rhythmic pulse.
Don’t use the thumb. It helps to be quiet and still while checking. It may take a few seconds to locate the pulse if the baby’s heart rate is weak.
Proper Rescuer Hand Position for Pulse Check
The correct hand position is simple but important. I place 2 fingers but not too close together, not too far apart. They should lie flat against the skin, not poking into it.
Infant’s arm should be stable, not flopping around. Sometimes I gently hold the back of the arm with my other hand to keep it still. The baby should be facing up, and the arm needs to be in a natural position. That helps avoid too much pressure or awkward angles, ensuring better accessibility and reliability during CPR.
Can Other Pulse Points Be Used in Babies
Yes, other pulse points exist like the femoral or carotid, but they’re not the first choice in infants due to their pulse rate being harder to detect. In fact, carotid pulse checks are avoided because the neck area is small and sensitive.
The femoral can be used by trained professionals, but it’s not easy to access in a diapered or clothed baby. It is located between the baby's pubic bone and the hip bone. You can find it just below the crease where the leg joins the abdomen
The difference is that you gently place fingers in the inner thigh to feel for a pulse. However, in my own training, instructors always told us to go straight to the brachial pulse for speed and safety. It’s just the most practical option.
CPR and Ongoing Pulse Monitoring
During infant CPR, you don’t just check the pulse once. You keep monitoring it, especially between cycles. Do not leave the victim unattended. Every 2 minutes, or after every 5 cycles of compressions per minute check breaths, stop and reassess.
I learned this during certification, and it becomes second nature with repetition. You don’t want to keep doing cardiopulmonary resuscitation immediately in a baby who has regained a pulse. You also don’t want to stop too soon. That’s why routine checks are vital. After reviving the infant, use the AED as soon as possible.
When to Check Pulse During a Baby CPR?
The pulse should be checked before starting CPR, and then again every 2 minutes. If you’re doing solo CPR, do a quick 10-second check right after calling for help.
During team-based cardiopulmonary resuscitation, one rescuer compresses while another checks and monitors the pulse rate for optimal effectiveness. I was taught never to pause CPR for more than 10 seconds to check a pulse. Quick checks are key to keeping the baby’s brain and heart oxygenated.
How Long to Check Pulse in an Infant?
Only check for 10 seconds—never more. Any longer and you delay lifesaving compressions. During that short window, feel for the brachial pulse.
If you’re unsure after 10 seconds, assume there's no pulse and start CPR.
This rule is drilled into everyone during training as part of the guide on the preferred method for infant CPR. It's better to do cardiopulmonary resuscitation in a baby who has a pulse than to wait too long and risk brain damage or death.
What to Do if No Pulse is Found in a Newborn?
If there’s no pulse or if the heart rate is under 60 beats per minute with signs of poor perfusion, start CPR right away.
Use two fingers for compressions in single-rescuer CPR or the two-thumb encircling technique in two-rescuer CPR.
Give 30 compressions followed by 2 breaths if alone, or 15 compressions and 2 breaths if with a partner, as outlined in high-quality CPR guidelines. Keep going until help arrives or the baby shows signs of recovery, ensuring the depth of the chest compressions is adequate.
Rescuer Tips for Accurate Pulse Check
Here are the tips I stick to in times of emergency response system. First is to stay calm due to its accessibility. Use the flat pads of your fingers, not tips. Don’t use your thumb. Don’t press too hard. Practice on a manikin if you can, as it provides a high-quality CPR training experience.
Keep the baby’s arm still. Stay focused. Don’t waste time; instead, focus on maintaining the correct pulse rate during compressions. Check in less than 10 seconds. If unsure, act. These small things can make a huge difference. The more I practiced, the faster and more confident I got.
Knowing the preferred method for checking infant pulse which is the brachial point, gave me the confidence to handle a real emergency. It's the best method for speed, accuracy, and safety when every second counts.
