Podcast 779: Pulse Pressure in Trauma

<strong>Contributor: Aaron Lessen, MD</strong> <strong>Educational Pearls:</strong> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Pulse pressure is the difference between the systolic and diastolic blood pressure, normal is about 40</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">A narrow pulse pressure is generally thought of as less than 30 mmHg which may signal peripheral vasoconstriction in response to lower blood volumes</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">2020 study examined hypotension and narrow pulse pressure in trauma and outcomes</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">37% of patients who were hypotensive on ED arrival had a severe injury, 22% of patients who had a narrow pulse pressure had a severe injury, and 11% of patients with normal blood pressure and normal pulse pressure had a severe injury</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Need for thoracotomy, death, cardiac arrest, and need for other interventions was highest in the hypotensive group, the lowest in the normal blood pressure/normal pulse pressure group, and narrow pulse pressure group outcomes fell in the middle</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Narrow pulse pressure in the setting of trauma may be a helpful vital sign to incorporate into trauma care in the ED</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Schellenberg M, Owattanapanich N, Getrajdman J, Matsushima K, Inaba K. Prehospital Narrow Pulse Pressure Predicts Need for Resuscitative Thoracotomy and Emergent Intervention After Trauma [published correction appears in J Surg Res. 2021 Oct 6;270:1]. J Surg Res. 2021;268:284-290. doi:10.1016/j.jss.2021.06.051</span></p> <p><em><span style="font-weight: 400;">Summarized by John Spartz, MS4 | Edited by Erik Verz