Radial pulse character relationships to systolic blood pressure and trauma outcomes.
BACKGROUND
Patient measurements that do not require monitoring equipment may be the only way to evaluate casualties in austere conditions to determine treatment and transport priority. Objective. To test the hypothesis that palpable pulse characteristics in the radial artery would estimate systolic blood pressure (SBP) and predict outcome in trauma patients.


METHODS
Data were analyzed from the medical records of 342 trauma patients ranging from 18 to 50 years of age. Prehospital data were collected by helicopter emergency medical personnel at the scene of the injury. Based on radial pulse character, patients were divided into normal (n = 313) and weak (n = 29) groups. Those whose medical records did not describe pulse characters were not considered. Differences in SBP, mortality, and medical interventions between the radial-pulse-character groups were evaluated.


RESULTS
The SBP taken at the scene was a mean of 26 mm Hg lower in those patients with weak radial pulse characters (102 mm Hg versus 128 mm Hg). Similarly, the lowest mean SBPs recorded in the field between the normal- and weak-pulse-character groups were 112 mm Hg and 99 mm Hg, respectively. Patient mortality increased with weak pulse character such that the mortality rats were 3% for the normal-pulse-character group and 29% for the weak-pulse-character-group (odds ratio = 15.2).


CONCLUSIONS
These preliminary data suggest that a weak radial pulse may be an acceptable method for initial rapid evaluation of trauma patients. This simple and rapid method of pulse evaluation should be considered for the triage of trauma patients in field conditions with limited instrumentation.
McManus
John
J
The U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas 78234-6315, USA. john.mcmanus@amedd.army.mil
Yershov
Andrey L
AL
Ludwig
David
D
Holcomb
John B
JB
Salinas
Jose
J
Dubick
Michael A
MA
Convertino
Victor A
VA
Hinds
Denise
D
David
Will
W
Flanagan
Tom
T
Duke
James H
JH
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D004632:Emergency Medical Services / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D011379:Prognosis; D011674:Pulse / Q000379:methods*; D017534:Radial Artery / Q000502:physiology*; D013599:Systole; D014218:Triage / Q000379:methods*; D014947:Wounds and Injuries / Q000175:diagnosis*