{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:54:28Z","timestamp":1790747668078,"version":"4.1.0"},"reference-count":18,"publisher":"The Korean Society of Emergency Medicine","issue":"3","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["ceemjournal.org"],"crossmark-restriction":true},"short-container-title":["CEEM"],"published-print":{"date-parts":[[2026,9,30]]},"abstract":"<jats:p>Objective: Healthcare providers frequently spend excessive time attempting to identify a pulse and may have difficulty accurately confirming its presence. Point-of-care carotid artery ultrasonography has been suggested as a potential alternative to manual palpation. This study aimed to evaluate the effectiveness of manual palpation, 2D carotid ultrasonography, and rapid increases in end-tidal carbon dioxide (EtCO2) levels for determining the return of spontaneous circulation (ROSC) in patients with cardiac arrest presenting to an emergency department.Methods: This was a single-center, prospective, observational study. Nontraumatic adult patients in cardiopulmonary arrest who were brought to the emergency department were included. After cardiac arrest was identified, the following data were recorded: initial arrest rhythm, ultrasonographic and manual pulse assessments, EtCO2 levels, resuscitation duration, and post-ROSC vital signs. The team leader\u2019s judgment was used for ROSC adjudication and served as the reference standard.Results: The investigation included 88 patients who underwent a total of 642 cycles of cardiopulmonary resuscitation. The area under the curve (AUC) values for 2D carotid ultrasonography, EtCO2, and manual palpation were 0.974, 0.802, and 0.862, respectively (all P&lt;0.001). In pairwise AUC comparisons, ultrasonography differed significantly from manual palpation (P=0.001) and EtCO2 (P&lt;0.001), whereas manual palpation and EtCO2 did not differ significantly (P=0.167). Bedside ultrasonography for detecting a carotid pulse had a sensitivity of 93.8% and a specificity of 100%.Conclusion: These findings suggest that 2D carotid ultrasonography can be effectively used to detect a pulse in patients with cardiopulmonary arrest.<\/jats:p>","DOI":"10.15441\/ceem.25.113","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T05:14:54Z","timestamp":1769663694000},"page":"311-317","update-policy":"https:\/\/doi.org\/10.15441\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of manual palpation, 2D carotid ultrasound, and end-tidal carbon dioxide for detecting return of spontaneous 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