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The carotid pulse is a pulse that can be taken on the right side of the neck over the carotid artery in order to determine heart rate. It is considered to be a more reliable site to measure than the wrist, particularly in individuals who have suffered some kind of trauma and/or who are in shock. Medical professionals will often measure heart rate via the carotid pulse when assessing cardiovascular health.
As it is the sole means of transporting oxygen via the bloodstream to the neck and head, the common carotid artery is the largest blood vessel above of the aorta. It is, in fact, a pair of blood vessels, with the right and left common carotid artery each supplying its respective half of the upper body. They are identical, except that the right carotid artery arises from the brachiocephalic trunk, another large artery that branches off the aorta and runs up the neck, while the left carotid originates in the chest at the top of the aortic arch.
In the neck alongside the thyroid cartilage, better known as the Adam’s apple, each side further divides into the internal and external carotid arteries. The external carotid artery is the outermost of the two, running up the front side of the neck under the jawbone and branching into smaller vessels from there. Taking a more direct route to the brain is the internal carotid artery, which runs vertically alongside the upper cervical vertebrae and enters the skull via the carotid canal, found inside the temporal bone.
Just below the division of the common artery into external and internal sections is where the carotid pulse is measured. The increase in pressure at this location before the blood splits off into two channels makes for a pulse that is strong and therefore easy to feel. Typically taken at the right carotid artery, the carotid pulse can be located by placing the first two fingers of the right hand upon the Adam’s apple and then sliding the fingers just to the right, into the hollow alongside it. Here the pulse should be distinct and the beats per minute easily counted.
There are several uses for the carotid pulse in detecting heart rate. During exercise, for instance, a person can palpate this spot on the neck to calculate her pulse in beats per minute, often by counting the beats for ten seconds and then multiplying by six. This is a useful tool for someone who needs to keep her pulse below a certain number, such as a pregnant woman or someone in cardiac rehabilitation. It is also useful for someone who is trying to get her heart rate up to improve her cardiovascular fitness, such as someone training for a triathlon.
Similarly, those trained in CPR are taught to find the carotid pulse to discover if an unconscious person still has a heart rate. After assessing the safety of the situation and calling 911, a trained person will check for breathing and then heart rate by palpating the carotid artery. If no pulse is detected, that person will commence CPR, or cardiopulmonary resuscitation.
When you see the police officer on TV touch the person's neck, they're checking for a carotid pulse. That's the one where they stand up and shake their heads, indicating the person is deceased.
A carotid pulse can also indicate a blockage in the carotid artery. If a doctor listens to the carotid area, he or she may be able to detect the "bruit," which is a distinctive sound the blood makes when rushing past an obstacle in the artery. The presence of the bruit does not tell the doctor what kind of blockage is present, or what is causing it, but this is a good indication he or she needs to follow up, usually with an ultrasound, to see where the blockage is, and what kind it is.
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