Concerning pulses, pressures, myths and facts

[trauma at emergencyunit.com]

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermTo
Search=10987771&ordinalpos=9&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_Resul
tsPanel.Pubmed_RVDocSum

Deakin rubbishes it. But as Deakin also rubbishes hypotensive resuscitation
on the entirely reasonable grounds that it is unproven: 

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermTo
Search=16098325&ordinalpos=6&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_Resul
tsPanel.Pubmed_RVDocSum

I doubt anyone here will listen.

BFM

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Carl Robert Christiansen
Sent: 07 October 2007 16:18
To: trauma-list at trauma.org
Subject: Concerning pulses, pressures, myths and facts


Hi all!
Even though I'm a representative of the lists lurkers, I'd like to chance it
on a question this time.

A myriad of emergency medical textbooks state that systolic pressure can be
guesstimated according to pulse location. I.e. a palpable radial pulse
equals systolic pressure above 80-90 mmHg, femoral pulse above 70-80 mmHg
and a carotid pulse above 60 mmHg. I've done several searches (medline,
google scholar, proquest and other local Norwegian sources) and can't find
neither a reliable or an unreliable source of evidence for such a claim. 

I have also been told (from a very unreliable source I might add) that this
claim comes from an old study done on pigs, and that the data was
extrapolated and transferred on to humans. And that a later study has
falsified the pulse-systolic pressure claim. I can't find any references on
this either.

So, is there anyone in here that knows of any strong sources to support
either claim? Is the dogma of radial>90sys, femoral>80sys and carotid>60sys
a myth or a fact?


Your humbly

Carl Christiansen
EMT
University Hospital of Northern Norway




PS.
The only related material I have found is this:

Charles D Deakin and J Lorraine Low. 2000. 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. http://www.bmj.com/cgi/content/full/321/7262/673 

DS.




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