Evidence map›Paper›PMID 40342519›Full record

ReviewResuscitation plus2025

Pulse check accuracy in pediatrics during resuscitation: a systematic review.

Stephan Katzenschlager, Jason Acworth, Lokesh Kumar Tiwari, Monica Kleinmann, Michelle Myburgh, Jimena Del Castillo, Vinay Nadkarni, Thomaz Bittencourt Couto, Janice A Tijssen, Laurie J Morrison and 3 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Resuscitation plus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Stephan KatzenschlagerHeidelberg University, Medical Faculty Heidelberg, Department of Anaesthesiology, Heidelberg, Germany.
Jason AcworthEmergency Department, Queensland Children's Hospital, Australia 501 Stanley St, South Brisbane, QLD 4101, Australia.
Lokesh Kumar TiwariDivision of Pediatric Pulmonology and Intensive Care, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India.
Monica KleinmannDepartment of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA, United States.
Michelle MyburghDepartment of Paediatrics and Child Health, University of the Free State, Bloemfontein, South Africa.
Jimena Del CastilloPediatric Intensive Care Department, Hospital General Universitario Gregorio Maranon de Madrid, Spain.
Vinay NadkarniDepartment of Anesthesia and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, United States.
Thomaz Bittencourt CoutoCentro de Simulação Realística and Faculdade Israelita de Ciências da Saúde, Hospital Israelita Albert Einstein, Brazil.
Janice A TijssenChildren's Hospital, London Health Sciences Centre, Paediatric Critical Care Medicine, Department of Paediatrics, Western University, Canada.
Laurie J MorrisonSunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Allan DeCaenUniversity of Alberta, Pediatric Critical Care Medicine, Edmonton, Canada.
Barnaby R ScholefieldDepartment of Critical Care Medicine, Hospital for Sick Children, ON, Canada.
International Liaison Committee on Resuscitation ILCOR ILCOR Pediatric Life Support Task Force

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aim of the study: Current guidelines advise rescuers to initiate cardiopulmonary resuscitation if a child is unresponsive, not breathing normally, and shows no signs of life. Manual pulse checks are considered unreliable and time-consuming. This systematic review evaluates the accuracy and duration of recommended pulse check methods during pediatric cardiac arrest and explores emerging diagnostic techniques. Methods: For this systematic review (PROSPERO ID CRD42024549535) three databases (PubMed, Embase, and Cochrane) were searched for articles published on this topic. An initial search was conducted on April 24, 2024, with an updated search using the same search strategy on February 16, 2025. Two authors independently screened the articles. One author extracted the data while a second author double-checked it. Quality and certainty of the evidence were evaluated using the QUADAS-2 and GRADE tools evaluated the evidence's quality and certainty. Studies were included if they compared manual pulse checks against alternative pulse check sites or other methods in pediatric patients. The data is presented descriptively. Results: A total of three studies were included. These studies involved 39 pediatric patients and a total of 376 pulse checks. Out of the 47 infants and children included, only 14 were in cardiac arrest. The remaining 33 patients were on mechanical circulatory support with either VA-ECMO or LVAD. In total, 183 nurses and 181 physicians performed 376 pulse or ultrasound checks. Due to their specialty, 122 nurses and 89 doctors were classified as experienced. Sensitivity and specificity of manual pulse check ranged from 76 to 100% and 64-79%, respectively. When experienced providers conducted pulse checks, sensitivity and specificity were higher (76-100% and 62-82%, respectively) compared to inexperienced providers (67-82% and 44-95%).The mean duration of pulse checks was 20 s, with an accuracy of 85%. Conclusion: Despite high heterogeneity among included studies, manual pulse checks only achieved moderate accuracy with a prolonged duration. This suggests that manual pulse checks are unreliable in children for determination cardiac arrest state and need for ongoing CPR.

Indexed as

Cardiac arrestPediatric Life SupportPulse checkResuscitationSystematic Review

Identifiers

PMID40342519
PMCPMC12059343

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.