During the primary survey of an unresponsive adult, how should you check the pulse and breathing?

• A. Check radial pulse for 30 seconds.
• B. Check carotid pulse for no more than 10 seconds while scanning for breathing.
• C. Check femoral pulse for 60 seconds.
• D. Check carotid pulse for 2 minutes.

Answer: (B)

During the primary survey of an unresponsive adult, you perform a rapid check of circulation and breathing. You assess the central carotid pulse and, at the same time, look for normal breathing, limiting the pulse check to about 10 seconds. This quick, simultaneous assessment helps you decide immediately whether there is a pulse and whether the person is breathing, guiding you to start CPR right away if needed. The carotid pulse is used because it reflects central perfusion and is more reliable in an unresponsive person than peripheral pulses like the radial pulse. Extending the check to 60 seconds or 2 minutes would waste crucial time and delay life-saving action. If you find a pulse but no normal breathing, provide rescue breaths; if there is no pulse, begin chest compressions immediately.