A physical therapist works with a four-month-old infant. During mat activities the infant suddenly becomes unconscious. Which of the following arteries is the MOST appropriate for the therapist to palpate to assess the infant’s pulse?

1. Radial
2. Brachial
3. Popliteal
4. Carotid

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A physical therapist works with a four-month-old infant. During mat activities the infant suddenly becomes unconscious. Which of the following arteries is the MOST appropriate for the therapist to palpate to assess the infant’s pulse?

1. Radial
2. Brachial
3. Popliteal
4. Carotid

A therapist should assess an unconscious patient for signs of cardiac arrest by assessing breathing and pulse. Checking for absent or abnormal breathing should occur by watching for movement of the chest for 5 to 10 seconds. Simultaneously, the pulse should be assessed for a minimum of 5 seconds—but no more than 10 seconds. The relatively small time interval is necessary to minimize the delay in starting cardiopulmonary resuscitation.

In an emergent situation such as the presented question, it’s only necessary to determine the presence or absence of a pulse. In non-emergent situations it’s beneficial to assess other pulse characteristics.

Rate often expressed in beats per minute

Strength often assessed from 0 indicating the absence of pulsation to 3+ indicating large or bounding pulsation

Rhythm often expressed as regular or irregular

If the patient has a pulse and is breathing normally, the patient should be monitored until emergency responders arrive.

If the patient has a pulse but is breathing abnormally, maintain the patient’s airway and begin rescue breathing.

If at any point, there is no pulse present, CPR should be initiated.

This particular question is asking….Which artery is the MOST appropriate to palpate to assess the infant’s pulse?

Let’s explore each of the options.

Option 1 - Radial
The radial and carotid arteries are the most commonly assessed arteries in the adult patient due to the relative ease of access. The radial artery is located at the wrist on the volar surface, (lateral to the flexor carpi radialis tendon and medial to the styloid process of the radius). It’s not easily palpated in an infant.

Option 2 - Brachial
The brachial artery is the most appropriate artery to assess on the infant. The artery can easily be palpated on the medial aspect of the midshaft of the humerus (medial to the biceps tendon and lateral to the medial epicondyle of the humerus). As a result, the artery provides the therapist with a timely and accurate method to assess the infant’s pulse. Hyperextending the infant’s arm often accentuates palpation of the brachial pulse.

Option 3 - Popliteal
The popliteal artery is the continuation of the femoral artery in the popliteal space of the knee, bifurcating into the anterior and posterior tibial arteries. The artery is often difficult to palpate, particularly in infants, and would therefore not be the best option.

Option 4 - Carotid
The carotid artery lies inferior to the angle of the mandible and anterior to the sternocleidomastoid muscle. The infant’s typical stature, small and chubby neck, make locating the carotid artery especially difficult in an emergent situation.

The correct answer is Option 2

Let’s explore the all student data:
5% of students selected Option 1, radial
53% of students selected Option 2, brachial, the correct response
7% of students selected Option 3, popliteal
35% of students selected Option 4, carotid

System Classification
This question is a Cardiovascular and Pulmonary Systems question which represents approximately 14% of all exam items.

Content Outline Classification
This question is a Physical Therapy Examination question which represents approximately 24% of all exam items.

Level Classification
This question is a Level 1 question since the question requires students to possess basic foundational academic knowledge. Remediation of Level 1 questions occurs through academic review of entry-level content using textbooks, review books, Basecamp, and flash cards.

Academic Focus Area
Looking to review related academic content? Check out pages 441-442 in PTEXAM: The Complete Study Guide.

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