Relation betwen B.P and radial pulsation.

[falcon-18]

Hello,
I want asking about relation betwen blood pressure and radial pulsation.
as I know if you feel radial that's mean systolic more than 80 and if no radial pulse that's mean below 80 .
I went to case 70yrs female with severe hypotension GCS 9/15 (first reading 60/35 second 57/38) pulse 96 spo2 94% RBS 80 PMH (DM, cancer in uterus)
and there is good radial pulse (normal ,regular)


How is it ? Can be or not?
thank you

falcon-18

 

[MrBrown]

Nah that's just one of those old myths that was disproven years ago

 

[the_negro_puppy]

Nah that's just one of those old myths that was disproven years ago

Indeed i've heard as such that the whole equating a sytolic BP to a radial, then carotid pulse is rubbish. Everyone is different with different diseases, injuries and pathologies of illness. While its a good guide, as you have seen, its not always correct

 

[Dutch-EMT]

It's not always correct, but we use it as guide in the field when no equipment for BP is available. When not feeling it, the patiënt can have a good pressure (v. radialis can be located deeper or when people are overweight).
When feeling radial pulse, it is plausible to say systolic BP is >80mmHg

 

[18G]

Agree with the others... the guesstimating B/P by the radial pulse is not accurate and has been debunked. However, still use the strength of pulses to get an idea of perfusion status and hypotension... its just not reliable to assume that u have a radial so u automatically have a SBP of at least 80.

 

[falcon-18]

It's not always correct, but we use it as guide in the field when no equipment for BP is available.

as I know we use it in primary assessment, and also as you said.

should be check in both arms also, I think.

thanks for all replies..

 

[rhan101277]

Yeah taught the same in medic school. It is to be used when quick "ballpark" readings are good. I would like to review the studies that debunked this.

Off topic:

What caused such low hypotension? Seems like she was in decompensated shock, did she have sepsis? Alot of possibilities, which is why I got into the profession because I like the challenge and like thinking. I will try not to let a call outcome lead to a strategy for a treatment to another patient who has the same symptoms.

 

[zzyzx]

Although I knew that the 80/70/60 rule was rubbish, I always thought that if you could feel a radial pulse then the patient would have somewhat decent BP, maybe 80 or 90.

But then earlier this year I had a patient with a good radial pulse whose BP was in the 70s. (The BP was confirmed with multiple readings, including at the ER.) So no, don't assume that because you feel a radial pulse that the patient has an adequate BP.

 

[mikie]

Yeah, I know how old this thread is.

Does anyone have any sources related to this? I have been using Google (I don't have extensive resources) but have not had much luck finding anything. A professor is pretty adamant about it being true, but I'd like to see some literature on the topic and have had little success.

Thanks.

 

[Aidey]

Search Pubmed

 

[usafmedic45]

Search Pubmed

That's www.pubmed.gov for the mentally handicapped or just plain :censored::censored::censored::censored:ing lazy amongst us.

 

[AnthonyM83]

That idea has long been debunked. ATLS taught that in 1985 and removed it in their 1997 curriculum.

The idea that the higher that you need higher pressures to produce more distal pulses is still important and should be taught, though.

Interestingly enough those studies debunking the myth also showed that you can have a minimum BP between 38 and 58 mmHg. So, when we're doing CPR, we're sometimes doing it on beating hearts

 

[lightsandsirens5]

Interestingly enough those studies debunking the myth also showed that you can have a minimum BP between 38 and 58 mmHg. So, when we're doing CPR, we're sometimes doing it on beating hearts

Yea, and what is really nice is when the monitor goes from VT /c pulse to VF as you roll the gurney out of the house. Then when you stop and blast them and you do your first compression they start flailing their arms. Then the whole way in they have no palpable carotid and no B/P (duh) no matter what rhythm the monitor shows, yet every time you go to compress the chest, they start fighting again.

And to top it all off the RN literally bellows (yes literally, in front of the family) at you afterward for not doing CPR on a pulseless patient. I'm sorry but if he has spontaneous respiratory drive and literally fights me every time I do a compression, I am not going to do CPR!

 

[medicRob]

The Deakin Study:

Deakin CD, Low JL. Accuracy of the advanced trauma life support guidelines for predicting systolic blood pressure using carotid, femoral, and radial pulses: observational study. BMJ.2000;321:673–674. . (16 September.)

It is the topic of the very first podcast of EMTLife, "The Myth of Pulse Palpate".

 

[systemet]

The Deakin Study:

Deakin CD, Low JL. Accuracy of the advanced trauma life support guidelines for predicting systolic blood pressure using carotid, femoral, and radial pulses: observational study. BMJ.2000;321:673–674. . (16 September.)

It is the topic of the very first podcast of EMTLife, "The Myth of Pulse Palpate".

And here's a link to the free .pdf full text for anyone who really really doesn't want to go to pubmed and type in "Deakin" and "Low" as search terms.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC27481/pdf/673.pdf

[As an aside, "www.pubmed.com" now also redirects to pubmed]

 

[systemet]

There's also some comments on the article here:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1119746/pdf/552.pdf

 

[mikie]

Thanks for the responses; I did read the one article by Deaken (though there are more dots than participants in the study, which makes me wonder about validity). PubMed was difficult; didn't yield much

thanks so far!

 

[8jimi8]

the deakin study:

Deakin cd, low jl. Accuracy of the advanced trauma life support guidelines for predicting systolic blood pressure using carotid, femoral, and radial pulses: Observational study. Bmj.2000;321:673–674. . (16 september.)

it is the topic of the very first podcast of emtlife, "the myth of pulse palpate".

haha

 

[yerkle]

I too have been able to palpate radial pulses with systolics <80 mm/Hg. All pts are different so I firmly believe in treating each pt individually, basing my treatment plan specifially on that pts needs.

 

[thinkABC]

Don't know about ya'll, but I've had very sick/elderly/frail patients while working transports where we have had extreme difficulty finding any pulse at all. Definitely not a radial. BPs usually in the 80s/90s.