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Title: Manual vs POCUS pulse checks

Category: Ultrasound

Keywords: CPR, POCUS, pulse checks (PubMed Search)

Posted: 10/6/2025 by Alexis Salerno Rubeling, MD (Updated: 7/21/2026)

A recent systematic review compared the timing and diagnostic accuracy of manual pulse check versus point-of-care ultrasound (POCUS) pulse checks (this means placing an ultrasound probe on the carotid or femoral artery to evaluate for a doppler pulse). 

The review included seven studies encompassing a total of 469 patients. 

Six of the studies assessed the duration of pulse checks, revealing a mean time difference of –1.39 seconds (95% CI: –2.20 to –0.57) in favor of ultrasound. 

Three of the studies reported the sensitivity and specificity of POCUS pulse checks, yielding pooled estimates of 99% sensitivity (95% CI: 87%–100%) and 96% specificity (95% CI: 85%–99%). In contrast, two studies evaluated manual pulse checks, with pooled sensitivity of 62% (95% CI: 22%–91%) and specificity of 91% (95% CI: 88%–93%). 

As with many systematic reviews, the studies included demonstrated high heterogeneity and generally low methodological quality, indicating that further investigation may still be needed.

References

Neto ES, Scapin M, Lazaro-Paulina F, Campbell RL, Molinari DF, Kummer T. Duration of resuscitation interruption using point-of-care ultrasound versus traditional manual pulse check: A systematic review and meta-analysis. Am J Emerg Med. 2025 Aug 23;98:145-152. doi: 10.1016/j.ajem.2025.08.049.


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