Physical Examination and Daily Assessment of the Critically Ill Patient

Evaluation of the relationship between peripheral pulse palpation and Doppler systolic blood pressure in dogs presenting to an emergency service

“…However, pulse palpation as a diagnostic test had a low sensitivity and positive predictive value for detecting hypotension, meaning that a dog with palpable metatarsal pulses could still be hypotensive. This finding is in contrast with previous anecdotal statements that DMP are only palpable when the SBP is at least 80–90 mm Hg . The data presented here indicate that DMP may still be palpable when the SBP is < 90 mm Hg.…”

“…Triage evaluation of dogs in an emergency setting must be rapid and accurate in order to properly assess tissue perfusion. Peripheral pulse palpation is one component of the triage examination heavily relied upon by veterinarians to assess the circulatory system . Digital palpation of peripheral pulses is recommended to help identify hypotension, arrhythmias, hyperdynamic states, decreased cardiac output, or peripheral vasoconstriction .…”

“…The utility of peripheral pulse palpation for identifying hypotension is controversial in the veterinary literature. Some authors state that evaluation of the peripheral pulse quality is a poor indicator of arterial blood pressure since normal pulse quality may be appreciated despite an abnormal systolic or diastolic blood pressure . Other authors suggest that peripheral pulse palpation is useful as a surrogate marker of blood pressure, and that the presence of a palpable dorsal metatarsal pulse (DMP) indicates a SBP of ≥ 80–90 mm Hg .…”

“…Peripheral pulse palpation is one component of the triage examination heavily relied upon by veterinarians to assess the circulatory system . Digital palpation of peripheral pulses is recommended to help identify hypotension, arrhythmias, hyperdynamic states, decreased cardiac output, or peripheral vasoconstriction . Pulse quality is determined by the pulse pressure, which is the difference between systolic blood pressure (SBP) and diastolic blood pressure, and depends on the stroke volume, arterial wall compliance, and intrathoracic pressure .…”

“…Digital palpation of peripheral pulses is recommended to help identify hypotension, arrhythmias, hyperdynamic states, decreased cardiac output, or peripheral vasoconstriction . Pulse quality is determined by the pulse pressure, which is the difference between systolic blood pressure (SBP) and diastolic blood pressure, and depends on the stroke volume, arterial wall compliance, and intrathoracic pressure . Digital palpation and evaluation of the strength of the peripheral pulse may allow for estimation of the blood pressure where a strong peripheral pulse reflects a normal or elevated SBP or reduced diastolic blood pressure, and a weak or absent pulse represents a low SBP or arterial clot formation …”