R.E.B.E.L.EM - Posted by Salim Rezaie
"In Advanced Trauma Life Support (ATLS), we learned that a carotid, femoral, and radial pulse correlates to a certain systolic blood pressure (SBP) in hypotensive trauma patients. Specifically ATLS stated:
- Carotid pulse only = SBP 60 – 70 mmHg
- Carotid & Femoral pulse only = SBP 70 – 80 mmHg
- Radial pulse present = SBP >80 mmHg
Is this true or a myth?
BOTTOM LINE: Although very small studies, they were done by two different authors, using different methods (BP cuff vs arterial line). Both came to the same conclusion: ATLS overestimates SBP based on palpation of radial, femoral, & carotid pulses. Another way to state this is, if using ATLS guidelines to guestimate BP, we are grossly underestimating the degree of hypovolemia our patients have.
UPDATE: These recommendations have now been removed from the 8th and 9th edition of ATLS"