Spot Pulses

Spot pulses are used to quickly assess for the presence of a pulse and not necessarily recommended for assessing a pulse rate. This technique helps you quickly determine if CPR is indicated.

Carotid Pulse

  1. Using the index and middle finger find your thyroid cartilage (Adam’s apple). Yes, all genders have this landmark!
  2. Which hand did you use? The right (or left)? Great, slide your fingers to the side of the body the assessment hand (right hand > right, left > left) into the groove created by your trachea (windpipe/throat) and your sternocleidomastoid (neck muscle on the front). We try to avoid reaching over the trachea (windpipe) when feeling for a carotid pulse.
  3. Gently press down, separating the trachea and sternocleidomastoid until you feel the beat.
  4. Find it? Pretty simple. Great! They won’t all be that obvious. Practice starting gently and applying pressure just until you feel it. All pulses will disappear if you push too hard, so use just enough pressure, not too much.
  5. Assess for 5 seconds, but no more than 10 seconds. This is to avoid prolonged pressure on the carotid artery that supplies the brain AND because this pulse is usually assessed in emergent situations, we don’t want to waste time looking for a pulse if there isn’t one.
  6. We usually don’t count the pulse using the carotid, so confirm the presence and move on.
imageA man wearing a glove places his right hand with pointer and middle fingers pressing into the right side of his neck, to the right of his Adam's locate carotid artery
Image by Nickolas Oatley, licensed under CC BY-NC 2.0.

Femoral Pulse

Due to proximity of the genitals, attempt femoral pulse assessments on yourself first. Be sure to obtain consent for all procedures practiced on others, especially more invasive ones like this.

    1. Lay flat.
    2. Using the front of your fingers, place your hand on the anterior (front) lateral (side) portion of your own lower abdomen under the waistband where the leg meets the abdomen. Gently press down with the front of your fingers until you locate a beat.
    3. When you find the beat, switch to using the tips of your index and middle finger to confirm presence.

Posterior Tibial Pulse

    1. Find the medial (inside) portion of the ankle. That big knobby bone is called the medial malleolus.
    2. Slide the tips of your index and middle finger posteriorly (towards the back) to the back of your ankle. Just as your fingers drop off into soft tissue, there is a tiny groove outlined by the medial malleolus and tendon of the gastrocnemius (calf muscle). It is right behind the bone.
    3. Gently press down with the tips of your index and middle finger until you feel the beat to confirm circulation to the lower limb.
Male with gloved hands, placing his pointer and middle finger on the dorsal aspect of a supine patient's to locate dorsalis pedal pulse. Patient has traction splint secured.
Dorsalis Pedis Pulse Location. Image by Holly Edwins, CC BY-NC-SA 4.0.
Spot Pulse Skills Verification Table











10 (instructor)

Location Assessed


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Oregon EMS Psychomotor Skills Lab Manual Copyright © 2023 by Chris Hamper, BS, NRP; Carmen Curtz, Paramedic, BS; Holly A. Edwins, Paramedic, B.S.; and Jamie Kennel, PhD, MAS, NRP is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.

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