Heartbeat assessment in infants: A comparison of four clinical methods

Armando Sarti, Fabio Savron, Veronica Casotto, Marina Cuttini

Research output: Contribution to journalArticle


Objective: To compare the performance of four clinical methods (apex ear auscultation; brachial, carotid, and femoral pulse palpation) for detecting and counting heart beat in infants. Design: Cross-sectional, repeated-measures study design. Prospective data collection. Setting: A postanesthesia care unit of a pediatric teaching hospital in Italy. Patients: Fifty-six normotensive sedated infants, aged 1-12 mos, were evaluated by 14 pediatric basic life support (PBLS)-qualified health professionals. Interventions: None. Measurements and main results: The proportion of successful heartbeat detections ranged from 60% with carotid pulse palpation to 98% with apex auscultation. Among successful detections, apex auscultation proved to be the most rapid way to detect heart rate (median, 4 secs) and the most accurate with a median discrepancy of 8 beats/min (vs. 12 with the other methods) from the electrocardiographic results. Differences between apex auscultation and pulse palpation were statistically significant (p <.0001). In contrast, no significant differences were found among the three methods of pulse checking. Conclusions: Apex listening is the most successful, rapid, and accurate method to detect and count the heartbeat by PBLS-certified professionals in normotensive infants without instruments. Pulse checking remains important for assessing the effectiveness of circulation. Palpating the brachial, carotid, or femoral pulse is equally effective.

Original languageEnglish
Pages (from-to)212-215
Number of pages4
JournalPediatric Critical Care Medicine
Issue number2
Publication statusPublished - Mar 2005


  • Basic life support
  • Cardiopulmonary resuscitation
  • Infants
  • Pulse palpation

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Pediatrics, Perinatology, and Child Health

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