ATLS’ 80/70/60 rule
On the basis of location of pulse palpable, minimum systolic blood pressure can be predicted as follows:
- Radial/Dorsalis pedis/Popliteal pulse: >80 mmHg
- Femoral pulse: >70 mmHg
- Carotid pulse: >60 mmHg
Overestimation of SBP by Pulses
Pulse characteristics are an unreliable sign and “should be used only as a last resort.”
The 80/70/60 rule taught by the prehospital medicine and older editions of ATLS courses tend to overestimate the patient’s blood pressure. This has been shown by two different studies.1 2
Although the radial pulse always disappears before the femoral, which always disappears before the carotid, most patient’s BP is lower than that predicted by these guidelines.
Note: These rules have been ommited in the newer editions of ATLS course.
Reference: Wilderness Medicine E-Book: Expert Consult Premium Edition – By Paul S. Auerbach