Carotid arterial pulse located just below the thyroid cartilage

Right followed by left carotid sinus massage, with a pause between

Massage and not occlusion should be done

Done first in supine position and then in erect posture if there no positive response in the supine position

3 sec asystole and / or 50 mm Hg fall in systolic pressure is taken as a positive response

Carotid bruit and recent myocardial infarction are contraindications

A very small risk of stroke / TIA has to be borne in mind