"If you can feel a pulse their BP is at least 90"

[nurseterry]

I need some facts.....I heard this quoted AGAIN just yesterday by a new grad nurse.

I just came from the ENA conference where a lecturer claims this isn't fact

Where did this statement come from

Is it true

Where can I find literature to prove or debunk it...because I am tired of hearing it. Frankly

[nurse2033, MSN, RN]

It was and still is used as a general rule of thumb in the Army. The old radial, 80, femoral, 70, carotid, 60 rule. However, I think it is often used and or interpreted incorrectly. Instead of a number, which is inaccurate and ultimately tells us nothing, we should instead focus on more important concepts. Currently, I see the teaching more on the lines of "if a patient has a palpable radial pulse and intact level of consciousness, then their brain is being adequately perfused."

This is much more helpful IMHO, and keeps people from focusing on some imaginary number that may or may not even be real.

Amen!

[drmorton2b]

This seems to be along the lines of you will catch a "cold" if you don't dress warm or stay out in the rain too long.

This does not seem plausible at all.

[LegzRN]

I've heard this before... but it's definitely not a good indicator of BP. The only time we ever used it is when I was a medic in the USAF.

[casi, ASN, RN]

If I am in a situation where I think a pressure might be acutely dropping I'll check peripheral pulses if we can't get a BP on an automatic cuff so I can get an idea if their BP is low or not. I'll also do this with comfort care patients that I don't want to bother with a tight uncomfortable BP cuff just so I can see where they might be in the dying process if they are starting to lose perfusion.

That being said I've seen people with SBP greater than 90 lose radial pulses and those with SBPs less than 90 with decent radial pulses. It really all depends on perfusion and what is normal for the patient.

[vamedic4, EMT-P]

It was and still is used as a general rule of thumb in the Army. The old radial, 80, femoral, 70, carotid, 60 rule. However, I think it is often used and or interpreted incorrectly. Instead of a number, which is inaccurate and ultimately tells us nothing, we should instead focus on more important concepts. Currently, I see the teaching more on the lines of "if a patient has a palpable radial pulse and intact level of consciousness, then their brain is being adequately perfused."

This is much more helpful IMHO, and keeps people from focusing on some imaginary number that may or may not even be real.

The above is true, and to add it is primarily used as a guideline to remember indications and treatment for shock. And several other factors have to be considered along with the numbers as well...as others have stated. If they're "shocky", they're going to have other, more important symptoms, like decreased LOC, diminished cap refill times, et cetera.

[dianah, ASN]

I have always heard, "the pedal pulses are palpable only if the SBP >70 mmHg."

This is borne out by Wound Care Made Incredibly Easy, p. 116, by Lippincott, Williams and Wilkins.

Perhaps this is what OP is speaking of?

Not just "the pulses" but more specifically the dorsalis pedis pulses? :)

[AOx1]

Not true. Only a guideline. I am small and my sbp is always in the 80s. I can assure you that I definitely have palpable pulses. I let the new students practice on me when feeling pulses. Even my popliteal is easy to find.

[GilaRRT]

The above is true, and to add it is primarily used as a guideline to remember indications and treatment for shock. And several other factors have to be considered along with the numbers as well...as others have stated. If they're "shocky", they're going to have other, more important symptoms, like decreased LOC, diminished cap refill times, et cetera.

Exactly, humans have a fatal flaw in that they like to assign a static and completely deterministic value to a specific concept. Unfortunately, shock cannot be defined by a certain number. So, even if a radial pulse always equaled 90 mmHg systolic, that number in a vacuum would be meaningless.

[Medic2RN, BSN, RN, EMT-P]

This concept is taught primarily with regard to triaging mass casualty incidents (at least that is what I thought). When I worked as a paramedic, the presence of the pulse and the general patient presentation were indicators (among a few others) as to what level to assign the patient. I have been in several MCI scenarios where hundreds of volunteer patients had to be triaged quickly. You only have a few seconds with each person. The radial pulse would indicate that their pressure is high enough to perfuse their periphery. I would not use this measure as the sole indicator of their well being though.

As far as using this technique in a hospital setting, I probably wouldn't unless I was in a MCI situation.