Check Your Own Pulse First

“Someone please get a pulse ox and a non-rebreather!”

My urgent voice sent two medical assistants running.

I walked into the room and the patient was working hard to breathe. He needed more oxygen and a monitor so we could see how much oxygen was circulating in his blood. The nurse on the medical-surgical floor knew her patient was not doing well, but even with her eight years of experience, froze in place.

“I can’t find anything on her!”

The Army medic was panicked. The woman was in the middle of the street, not breathing.

“Check for a pulse again, and start CPR!” I hollered, as I moved on to triage the other six victims of the horrible head-on collision.



“Yes Sergeant Rod?” I answered quickly, automatically turning to the non-commissioned officer, who was my supervisor and mentor.

“You get called out to a gun shot wound to the chest. Training accident. That is all you know. GO!”

This was a game we played. A very serious game. He had taken it upon himself to help mentally and physically prepare me for a chance at a flight medic slot. We ran scenarios verbally when we had a few minutes between patients in the clinic, before formation, or during down time out in the field.

“Is my scene safe, perimeter secure?” I automatically ask.


“BSI! I’m approaching my patient, what do I see?”

“You see a bunch of freaked out infantry soldiers screaming at you to help their buddy who is on his back in the dirt gurgling for breath.”

“I’m approaching my patient, and I ask his name. Can he talk to me?”

“WRONG!” Sergeant Rod yells.

I look at him dumbfounded.

He tries to keep a straight face. He waits for me to process the scenario.

I finally give up. Nothing frustrates me more than being stumped. Although I’m getting flustered, I ask instead of guessing. Guessing had gotten me into much more trouble than simply admitting I didn’t know.

“Jag, I’m only gonna tell you this once, so listen up.”

My brain went on record. This was not going to simply be important, it was going to be profound.

“Always, always, ALWAYS check your own pulse first.”

I stayed silent, intent on his words.

He went on, “It doesn’t matter how ugly the situation is, it doesn’t matter how chaotic or how crazy everyone around you is. If you don’t check your own pulse, have your own wits about you, you will not be able to keep yourself, or your crew safe. You must have control or you will lose the big picture. Losing that focus will narrow your view and you will miss something. It will kill your patient faster than his injuries will. In our line of work, it will get you killed as well.”

That advice has served me well.

When we are on final approach landing on an accident scene and the patient report has my adrenaline working I will still, to this day, find my fingers on my carotid, feeling my pulse. The simple act of palpating my heartbeat, feeling the pulsation against my fingertips, centers my mind. It calms my breathing, and usually makes me smile once I realize that old habits remain.

I know Sergeant Rod didn’t mean for me to physically check my pulse. He wanted my mind aware, my eyes open, and my focus to be on the basics. He wanted me to think about the safety of myself and my crew and airway, breathing, circulation of my patient.

Sergeant Rod—-I listened up.

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  1. Is this universal in technical, dangerous work?
    First order of business for a pilot with an emergency…
    Flight 401 in Miami… a perfectly good aircraft flown into the swampy ground because two professional pilots forgot rule #1. Many died.
    I tell my students, “Take a deep breath”…
    Serves the same purpose.

  2. You know, it works in non-life threatening situations as well. In my past life as a political hack, I found myself in New York for the National Convention. One day, my boss was losing it. A common occurance when dealing with high strung, egomaniacal politicos. But my boss was really going ballistic at another person in the office. I stepped between the two, asked if I could have a moment, took him into his office and told him to get the F#$k out of the building. I believe the sentence went something like this:

    “Take your Walkman and get the f#&k out of here before you do some real damage. Go sit on a bus stop bench, breathe deeply and calm down. If that won’t work, go scream at a stranger out on Broadway, it’s New York, their used to it, just don’t come back until you’re calm.”

    Luckily he took my advice instead of firing me on the spot.

  3. Hey Emily!
    This is the same advice my EMT-B instructor gave me. To the letter.
    “Take your pulse. Take a deep breath.”
    I forget to do that at times, but it’s some of the best advice I’ve ever gotten.

  4. Interesting to see that it has worked in other situations as well. I actually use it in almost everything I do but don’t realize it most of the time.

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