title: Auscultate, palpate and tap: time to re-evaluate.
abstract: OBJECTIVE
  To determine the accuracy of current methods of heart rate (HR) assessment.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Paediatrics and Child Health, University College Cork, Cork, Ireland.|Irish Centre for Fetal and Neonatal Translational Research (INFANT), Cork, Ireland.
authors: G A
authors: GA
authors: Hawkes
authors: Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.|National Children's Research Centre, Dublin, Ireland.
authors: C P
authors: CP
authors: Hawkes
authors: Department of Paediatrics and Child Health, University College Cork, Cork, Ireland.|Irish Centre for Fetal and Neonatal Translational Research (INFANT), Cork, Ireland.
authors: M
authors: M
authors: Kenosi
authors: Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland.
authors: J
authors: J
authors: Demeulemeester
authors: Department of Paediatrics and Child Health, University College Cork, Cork, Ireland.|Irish Centre for Fetal and Neonatal Translational Research (INFANT), Cork, Ireland.
authors: V
authors: V
authors: Livingstone
authors: Department of Paediatrics and Child Health, University College Cork, Cork, Ireland.|Irish Centre for Fetal and Neonatal Translational Research (INFANT), Cork, Ireland.|Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland.
authors: C A
authors: CA
authors: Ryan
authors: Department of Paediatrics and Child Health, University College Cork, Cork, Ireland.|Irish Centre for Fetal and Neonatal Translational Research (INFANT), Cork, Ireland.|Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland.
authors: E M
authors: EM
authors: Dempsey
mesh_terms: D006326:Heart Auscultation; D006339:Heart Rate; D006801:Humans; D007231:Infant, Newborn; D010173:Palpation; D012151:Resuscitation
keywords: Heart Rate; Infant; Neonatal; Pulse; Resuscitation