Checking for a Pulse.
    Assess the need for cardiopulmonary resuscitation (CPR). Check for pulses for 10 seconds at the neck or groin . Use the tips of your index and middle fingers to feel for a pulse. Do not use your thumb, because this finger often has pulsations of its own, which you may confuse with the victim's pulse.

    Do not rely upon the wrist for the determination of heartbeat. The carotid artery is located at the level of the Adam's apple, between thCis structure and the large muscle (sternocleidomastoid) that runs from the base of the ear to the collarbone. Pulsations from the femoral artery may be felt below the abdomen in the groin crease where the front of the leg attaches to the trunk, two finger breadths medial (toward the center) to the midpoint in the line from the hipbone (anterior iliac spine) to the bony region directly under the pubic hair (the pubic symphysis). Other locations where the pulse may be felt (often with great difficulty) are on the inner aspect of the elbow; behind the knee; directly behind the bony prominence (malleolus) on the inner side of the ankle; and centrally on the top of the foot.

    A normal resting pulse rate is 55 to 90 per minute for adults, 80 to 110 per minute for small children, and 100 to 130 per minute for infants. A well-conditioned athlete will often have a resting pulse rate of 45 to 50 per minute, because the well-developed vagus nerve's impulses dominate. Failure to feel a pulse means that the heart is not beating (cardiac arrest), the pump (heart) is not squeezing with sufficient force (profound shock or hypothermia), the artery is constricted (hypothermia), there is an injury to the artery (from a fracture or severe cut), or you are feeling in the wrong place.

If no pulse is detected (and the victim is unconscious and not breathing), send someone for help, give two breaths to the victim, and begin the chest compressions of cardiopulmonary resuscitation (CPR).