Online CPR Certification Blog

When someone collapses or appears unresponsive, every second counts.
In those first critical moments, your ability to check for breathing and a pulse accurately determines what happens next — whether you begin CPR, place the person in the recovery position, or simply monitor them until help arrives.

Many people panic during such situations and either freeze, guess, or skip vital checks, wasting precious time. Yet these two simple assessments — breathing and pulse — form the foundation of life support.

In this guide, we’ll walk you through the science, technique, and step-by-step method of checking for breathing and a pulse accurately and safely, just like trained first responders do.
You’ll learn when to do it, how to do it, and how to interpret what you find — all while keeping yourself calm and confident.

Why Checking for Breathing and a Pulse Matters

Your first priority in an emergency is to find out whether the person is:

• Breathing normally, and
• Has a pulse (heartbeat).

If either one is missing, the body isn’t getting oxygen, and brain damage can start within 4–6 minutes.
Quick, accurate checking allows you to:

• Decide if CPR or rescue breathing is needed.
• Identify life-threatening cardiac arrest early.
• Avoid unnecessary chest compressions on someone who doesn’t need them.
• Provide valuable information to emergency responders.

In short — before any medical help arrives, you are the first link in the chain of survival.

Understanding the Basics: Breathing vs. Pulse

Before diving into the steps, let’s clarify what you’re checking for.

Breathing

• Means the lungs are taking in air and the chest is rising and falling.
• The air movement can be seen, heard, or felt.
• “Normal breathing” is smooth, rhythmic, and effortless.

Pulse

• Indicates blood circulation from the heart.
• A pulse is felt as a gentle throb in an artery where it passes close to the skin and over bone.
• The most reliable spot for unconscious adults is the carotid artery in the neck.

You must check both quickly but carefully — within 10 seconds for each.

Before You Start: Scene Safety and Initial Assessment

Never rush in without assessing the environment.
Before checking the person:

• Ensure the scene is safe.
  Look for dangers like traffic, fire, or electricity. Your safety comes first.
• Check responsiveness.
  Tap their shoulders firmly and shout: “Are you okay?”
  If there’s no response, proceed.
• Call for help.
  If someone is with you, ask them to call emergency services and bring an AED (Automated External Defibrillator) if available.

Now, it’s time to check for breathing and pulse.

Part 1: How to Check for Breathing

Step 1: Open the Airway

An unresponsive person’s tongue can fall back, blocking airflow.
Use the head-tilt/chin-lift technique unless you suspect a spinal injury.

• Place one hand on the person’s forehead.
• Place two fingers of your other hand under the chin.
• Gently tilt the head back while lifting the chin upward.

If you suspect trauma (like a car accident or fall), use the jaw-thrust maneuver instead:

• Place your hands on both sides of the jaw.
• Push the jaw upward without tilting the head.

This opens the airway safely.

Step 2: Look, Listen, and Feel (No More Than 10 Seconds)

Position your ear and cheek close to the person’s mouth and nose while looking toward their chest.

• Look for chest movement.
• Listen for breath sounds.
• Feel for air movement on your cheek.

Observe for no more than 10 seconds — counting “one-one-thousand, two-one-thousand…” to keep time accurately.

If the person is breathing normally:

• Place them in the recovery position and continue to monitor.

If breathing is absent or abnormal (gasping, irregular, snorting):

• Treat as no breathing and proceed to check for a pulse immediately.

What Normal vs. Abnormal Breathing Looks Like

Type	Description	Action
Normal breathing	Regular, quiet, chest rises evenly	Monitor and keep airway open
Agonal gasps	Irregular, slow, noisy, or occasional breaths	Treat as no breathing, start CPR
No breathing	No chest movement, no air felt	Begin CPR

Part 2: How to Check for a Pulse

When checking the pulse, always use your index and middle fingers, never your thumb — your thumb has its own pulse and may confuse you.

Step 1: Choose the Right Pulse Point

Depending on the person’s age and condition, use the following:

Person	Pulse Site	Location
Adult & Child (unconscious)	Carotid artery	Side of the neck
Infant (under 1 year)	Brachial artery	Inside of upper arm, between elbow and shoulder
Conscious adult	Radial artery	Wrist, thumb side

Step 2: Locate the Carotid Pulse (Adults & Children)

• Kneel beside the person.
• Place two fingers on the Adam’s apple (trachea).
• Slide your fingers 2–3 cm to one side (toward you).
• Press gently — not too hard — into the groove between the trachea and neck muscle.

Hold your fingers there and feel for a pulse for up to 10 seconds.

If you feel a pulse:
The heart is beating — continue checking breathing and monitor closely.

If no pulse is detected:
Begin CPR immediately (30 chest compressions followed by 2 rescue breaths).

Step 3: Checking the Brachial Pulse (Infants)

For babies under 1 year:

• Place the baby on their back on a flat surface.
• Put two fingers on the inside of the upper arm, between the elbow and shoulder.
• Press gently against the bone or muscle — never too hard.
• Feel for a pulse for up to 10 seconds.

If no pulse or breathing is present, start infant CPR immediately.

Step 4: Avoid Common Mistakes

• Don’t use your thumb.
• Don’t press too firmly — it can block blood flow.
• Don’t check for longer than 10 seconds.
• Don’t delay CPR if you’re unsure — it’s better to act than hesitate.

How to Coordinate Both Checks

The breathing and pulse checks should occur simultaneously when possible.

Here’s how professionals do it:

• Open the airway (head-tilt/chin-lift).
• Keep one hand near the jaw to maintain the airway.
• Use the other hand to feel for the carotid pulse.
• Simultaneously look, listen, and feel for breathing.

This ensures no precious seconds are wasted.

Understanding What You Find

Once you’ve checked, interpret your findings quickly:

Breathing	Pulse	Action
Present	Present	Place in recovery position, monitor
Absent	Present	Begin rescue breathing (1 breath every 5–6 seconds)
Absent	Absent	Start CPR (30 compressions : 2 breaths)
Abnormal (gasping)	Unclear	Treat as cardiac arrest, start CPR

The Role of Time: Why 10 Seconds Matter

The American Heart Association (AHA) emphasizes the 10-second rule for a reason:
The longer you check, the longer the person goes without help.

Brain cells start dying within 4–6 minutes of oxygen loss.
So, if you can’t confirm breathing or a pulse within 10 seconds — start CPR immediately.

Tips for Accurate Checking

• Stay calm and focused. Panic can make you miss subtle signs.
• Remove noise distractions. Move closer to the victim’s face.
• Use proper lighting if it’s dark.
• Keep your hands steady — trembling can confuse your perception.
• Check again every 2 minutes if CPR continues.

Special Considerations

1. Drowning or Overdose Victims

They might have a weak pulse or slow breathing.
If in doubt, start CPR — chest compressions will not harm someone with a pulse, but doing nothing can kill someone without one.

2. Infants and Small Children

Their breathing and pulse rates are much faster than adults.
Don’t confuse normal fast breathing with distress.

Age	Normal Breathing Rate	Normal Pulse Rate
Infant (0–1 yr)	30–60 breaths/min	100–160 bpm
Child (1–8 yrs)	20–30 breaths/min	80–120 bpm
Adult	12–20 breaths/min	60–100 bpm

3. Cold Environments or Hypothermia

Pulse and breathing can be extremely slow — take extra time to check (but not over 10 seconds). Begin CPR if unsure.

4. Trauma and Bleeding

If severe bleeding is present but no pulse detected, control bleeding immediately and start CPR.

Tools and Technology That Can Help

1. Automated External Defibrillator (AED)

Modern AEDs can detect heart rhythms and guide you through CPR steps. Follow its voice prompts — it simplifies the process.

2. Smartwatches and Heart Rate Monitors

Some advanced devices can detect pulse irregularities or absence, but never rely solely on them in emergencies.

3. Pulse Oximeters

These measure oxygen saturation and pulse rate, useful for medical professionals — but manual checks remain the gold standard in emergencies.

Myths About Checking Breathing and Pulse

• You can always tell if someone’s breathing by looking.
  False. Gasping or shallow movements can be misleading.
• Feeling for a pulse is easy.
  Not always. It takes calm focus, proper technique, and practice.
• You might hurt someone by doing CPR if they have a pulse.
  The risk is minimal — not acting is far more dangerous.
• You must check for a full minute.
  Incorrect. 10 seconds is the international standard.

What to Do After the Check

Once you’ve assessed the situation:

• If the person is breathing and has a pulse, place them in the recovery position.
• If the person isn’t breathing but has a pulse, start rescue breathing:
  • 1 breath every 5–6 seconds for adults.
  • 1 breath every 3–5 seconds for infants/children.
• If both are absent, start CPR immediately.
• Continue until:
  • The person starts breathing or moving,
  • Professional help arrives,
  • You become too exhausted to continue.

The Science Behind the Checks

Checking for breathing and pulse is rooted in basic human physiology:

• Breathing involves the brainstem’s respiratory center sending signals to the diaphragm and intercostal muscles.
• Pulse reflects cardiac activity — the rhythmic pumping of blood through arteries.

Together, they indicate that oxygen exchange and circulation are functioning.
When either stops, cell death begins almost instantly, making your early detection vital.

Practice Makes Perfect

Skill comes from repetition. To master breathing and pulse checks:

• Take a certified CPR & First Aid course.
• Practice on training mannequins to feel real chest rise and pulse points.
• Time yourself to stay within the 10-second rule.
• Practice under mild stress or simulated emergencies to build composure.

The more you practice, the more confident and effective you’ll be during real emergencies.

Legal Protection: The Good Samaritan Law

If you act in good faith to help someone during an emergency, you’re generally protected under Good Samaritan Laws.
These laws exist to encourage bystanders to assist without fear of legal consequences — provided you:

• Act responsibly and within your training.
• Avoid reckless or harmful actions.
• Stay until professional help arrives (if possible).

Your quick, sincere help can never be legally punished when done safely.

Emotional Aftercare for Rescuers

It’s normal to feel anxious, shaky, or emotional after helping in a life-threatening situation.
Afterward:

• Take deep breaths and rest.
• Talk to someone about the experience.
• Recognize that you did the right thing.

Caring for yourself ensures you’re ready to help again if ever needed.

Summary: The Key Takeaways

Check safety first.
Check responsiveness.
Call for help.
Open the airway.
Look, listen, and feel for breathing (10 seconds).
Feel for pulse (10 seconds).
Act based on what you find.

Conclusion

Checking for breathing and a pulse accurately is one of the most important emergency skills you can learn.
It takes less than 20 seconds, but those seconds can determine whether someone lives or dies.

When done calmly and correctly, these checks give you the clarity to:

• Start CPR when it’s needed,
• Avoid unnecessary actions when it’s not, and
• Keep the person stable until help arrives.

Remember:

Stay calm. Stay focused. Act fast.

You don’t need to be a medical expert to save a life — you just need to know what to look for and how to respond.

Call to Action

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