Auscultate, palpate and tap: time to re-evaluate

Acta Paediatrica
G A HawkesE M Dempsey

Abstract

To determine the accuracy of current methods of heart rate (HR) assessment. All participants palpated a simulated pulsating umbilicus (UMB), listened to a tapping rate (TAP) and auscultated a simulated HR (AUSC). A simulated HR of 54, 88 and 128 beats per minute (bpm) was randomised for all methods. Twenty-nine healthcare staff participated in this study. Correct assessment of HR of 54 bpm as being within the 0-59 range occurred in 17.2% UMB, 17.2% TAP and 31% AUSC and was obtained in <10 seconds by 48.3%, 65.5% and 62.1%, respectively. A rate of 88 bpm was correctly assessed as within the 60-100 range in 82.8% UMB, 79.3% TAP and 79.3% AUSC and was obtained in <10 seconds by 55.2%, 58.6% and 55.2%, respectively. A rate of 128 bpm was identified as >100 bpm by 96.6% UMB, 93.1% TAP, and 93.1% AUSC and was obtained in <10 seconds by 51.7%, 55.2% and 62.1%, respectively. Current methods in assessing rates below 60 bpm are inaccurate and may overestimate HR. We recommend that these methods alone should not be relied upon in neonatal resuscitation and objective assessment of heart rate should be readily available at all newborn resuscitations.

References

Jun 26, 2002·Journal of Perinatology : Official Journal of the California Perinatal Association·Daksha Patel, Zdzislaw H Piotrowski
Mar 24, 2004·Resuscitation·Catherine Jane Owen, Jonathan Peter Wyllie
Sep 23, 2006·Resuscitation·C Omar F KamlinColin J Morley
May 21, 2010·Resuscitation·Kevin G J A VoogdtJonathan P Wyllie
Jun 16, 2010·Journal of Paediatrics and Child Health·Ben GelbartCharles Barfield
Nov 3, 2011·Pediatrics International : Official Journal of the Japan Pediatric Society·Hiroshi MizumotoDaisuke Hata

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Citations

Apr 12, 2016·Frontiers in Pediatrics·Daragh FinnEugene M Dempsey
May 12, 2017·Paediatric and Perinatal Epidemiology·Sven CnattingiusThomas Frisell
Apr 1, 2018·Acta Paediatrica·Susanna Myrnerts HöökTobias Alfvén
Aug 8, 2020·BMJ Paediatrics Open·Susanna Myrnerts HöökTobias Alfven
Nov 4, 2017·PloS One·Anup KatheriaNeil Finer
Feb 17, 2019·Journal of Perinatology : Official Journal of the California Perinatal Association·Nathan MoneyVinisha Singhi

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