Correct way to take a carotid pulse

BLS and ACLS instructors have corrected my pulse-taking, saying it MUST be done with the left hand and on the same side of the patient that I'm on. I always reach instinctively with my right hand (it's more deft and sensitive) and to the opposite side of the patient (which I find is less awkward to reach and to find the right spot). I've never gotten a satisfactory answer about why this is important. It seems like an odd bit of minutia to hang onto in these days of simplification. And it isn't specified in the ACLS manual (surely it would be, if it was important?). Any thoughts?
I have honestly never thought about it before!

Tell these instructors to show you where it says that in the ACLS/BLS manual or the research behind only taking the carotid with the left hand. You can take a carotid pulse with either hand. Which ever way seems the most comfortable and gets the job done is the hand you should use.

I just pulled out my BLS manual. The only references to position are for CPR teams where the BVM is at the head and the AED and CPR people are on opposite sides of the body for access.My guess is that your instructor is probably following a paint-by-colors teaching guide with a picture of someone using their left hand...Though thinking about it if the pulse is stronger on one side of the neck that might explain why I walk in circles all the time :spin:

I've heard the same thing from instructors, the only rationale anyone ever provided was that checking the pulse on the opposite side may increase the risk of occluding the vessel or manipulating his larynx. I don't buy either argument.As for the left hand, I would want to know how it could possibly make any difference which hand you used. If someone were able to palpate it with their big toe it would be fine with me.

I've always used my right hand and the left side of the patient - not killed anyone yet!

Quote from getoveritI've heard the same thing from instructors, the only rationale anyone ever provided was that checking the pulse on the opposite side may increase the risk of occluding the vessel or manipulating his larynx. I don't buy either argument.As for the left hand, I would want to know how it could possibly make any difference which hand you used. If someone were able to palpate it with their big toe it would be fine with me.

I agree that we should not say "I've always done it this way, never got into trouble with it, so I will keep doing it this way" in the place of doing it the best way as proven by evidence. I definitely see the rationale for taking the pulse on "your" side, not the opposite side. I cannot, however, buy the idea that it must be done with the left hand. I understand the point about the sympathetic response being stronger on the dominant side, but what if the student/provider is left handed? It seems wierd to base everything we do on evidence/statistics and then say "eh, we'll do it this was because there are more righties that lefties."I have never been told by an ACLS/BLS instructor which hand to use to take a pulse. It seems to me that in the situation descibed they are not telling you to use the left hand because they know of evidence behind the practice...

Quote from psu_213I have never been told by an ACLS/BLS instructor which hand to use to take a pulse. It seems to me that in the situation descibed they are not telling you to use the left hand because they know of evidence behind the practice...

As mentioned ^^^, I think they want your right hand to be ready to get back to compressions ASAP. Every second counts.

Quote from Rob72 As with most "Standards", it tries to cover the majority, most of the time. Most right handed practioners will position themselves on the pt's left side, if given a choice. In this position, the right hand can be locating the xiphoid, while the left gets a pulse/absence thereof. Part of it is rationale, part of it is statistics.

Good catch- I did mean on the pts right.

Quote from Rob72 As with most "Standards", it tries to cover the majority, most of the time. Most right handed practioners will position themselves on the pt's left side, if given a choice. In this position, the right hand can be locating the xiphoid, while the left gets a pulse/absence thereof. Part of it is rationale, part of it is statistics.