Does Presence of Peripheral Pulses Accurately Predict Systolic BP?

According to advanced trauma life support (ATLS) guidelines, systolic blood pressure (SBP) can be estimated from peripheral pulse presence: SBP is 60 to 70 mm Hg when only the carotid pulse is present, 70 to 80 mm Hg with a femoral pulse, and above 80 mm Hg with a radial pulse. In this British study, researchers used invasive arterial catheters to measure blood pressure in 20 consecutive patients with hypovolemic shock while an observer blinded to blood pressure palpated radial, femoral, and carotid pulses.

As expected, in each case, the radial pulse disappeared before the femoral pulse, which disappeared before the carotid pulse. When all pulses were present, 10 of 12 patients (83 percent) had SBP below the expected level of 80 mm Hg (range…