Pulse—Weak or Absent
When a person is seriously injured or ill, you may have difficulty feeling a pulse. The pulse is the rate of your heart beats. It can be palpated or felt at different pulse points in the body such as the wrist, the neck, and the groin. When the pulse is absent, you are unable to feel the pulse from any pulse point on the body. A weak or absent pulse is considered a medical emergency. This symptom usually indicates a serious problem from within the body, and it should never be overlooked. Usually, a person with a weak or absent pulse will have difficulty moving or speaking. If someone is in this condition, call 911 immediately.
What Causes a Weak or Absent Pulse?
There are many causes for a weak or absent pulse. Whatever the cause, it is a medical emergency. The most common causes are cardiac arrest and shock. Cardiac arrest occurs when the heart stops beating. Shock is when the body begins to shut down, causing a weak pulse, rapid heartbeat, shallow breathing, and unconsciousness. Shock can be caused by anything from dehydration to a heart attack.
A person can also mistakenly report a weak pulse if the pulse isn’t taken correctly. One of the more accessible pulse points in the wrist should be palpated by placing the index and middle finger firmly over the underside of the wrist, below the base of the thumb. If taking the pulse at the neck, you should place the index and middle finger just to the side of the Adam’s apple, in the soft, hollow area and press firmly to feel the pulse (Medline).
Once you find the pulse, count the beats for 1 full minute or for 30 seconds and multiply by 2. This will give the beats per minute.
Some people may normally have a weak pulse. However, equipment used to measure the pulse will usually pick it up properly.
Identifying a Weak or Absent Pulse
A weak or absent pulse can normally be identified by checking a pulse point on the neck or the wrist with your finger. A pulse oximeter can also be used. This is a small monitor worn on the fingertip to measure the oxygen levels in the body. Other symptoms may also be present, such as
- low blood pressure
- rapid or irregular heart rate
- shallow breathing
- clammy skin
- chest pain
- shooting pain in the arms and legs
A weak or absent pulse is a medical emergency. Call 911 immediately.
If the person who has the weak or absent pulse has no effective heart beat, cardiopulmonary resuscitation (CPR) should be performed.
Before beginning, determine whether the person is conscious or unconscious. If you’re not sure, tap on the person’s shoulder and ask loudly, “Are you OK?”
If there is no response and a phone is handy, call 911. (If someone else is available, have him or her call 911.) If you are alone and the person is unresponsive because of suffocation (e.g., from drowning) begin CPR for one minute, then call 911.
If you are trained in CPR and confident of your abilities, start with 30 chest compressions, then check the airway and give rescue breaths if needed. Continue CPR until there is movement or until paramedics arrive.
If you are not trained in CPR, then provide hands-only CPR. That means give chest compressions at the rate of about 100 per minute until the person moves or paramedics arrive.
To give chest compressions:
- Lay the person on a firm surface. (Do not move the person if there appears to be a spinal injury or head injury.)
- Walk to the person’s side and kneel down.
- Place one of your hands on the person’s chest and place your other hand on top of the first.
- Lean in with your shoulders and apply pressure to the person’s chest by pushing down at least 2 inches. Make sure your hands are positioned in the center of the person’s chest.
- Count one, and then release the pressure. Keep doing these compressions at the rate of 100 per minute until the person shows signs of life or until paramedics arrive.
In 2010 the American Heart Association released updated guidelines for CPR – access the AHA’s updated guidelines here. If you are not trained in CPR but would like to be, call your local Red Cross for information on classes in your area.
At the hospital, the doctor will use pulse monitoring equipment to measure the person’s pulse. If there is no effective heartbeat or the person isn’t breathing, the emergency staff will administer appropriate care to restore the vital signs.
Once the cause is discovered, the doctor will prescribe necessary medications or give a list of things to avoid, such as foods that cause allergies.
If necessary, the person will follow up with his or her primary care physician.
What Future Health Complications Can Be Expected?
If you received CPR, you may have bruised or fractured ribs. If your breathing or heartbeat stopped for a significant amount of time, you may have organ damage due to tissue death from lack of oxygen.
More serious complications may occur if there is no effective heart beat and the pulse is not restored quickly enough:
- Coma- typical following cardiac arrest and due to lack of blood and oxygen to the brain
- Shock- insufficient blood pressure to maintain normal functioning of vital organs
- Death- lack of adequate circulation and oxygen to the heart muscle
Cardiac arrest is the leading cause of death in the U.S., usually due to coronary heart disease (atherosclerosis).