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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

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lunes, 19 de diciembre de 2016

Palpable blood pressure estimates

ATLS
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"