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The Lin Sessions: Tricks of the Trade and ATLS Mythbusting

Salim Rezaie, MD FAAEM and Michelle Lin, MD
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No me gusta!

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EM:RAP October 2013 Written Summary 2 MB - PDF

Michelle is back with 2 segments this month. She begins by dropping a few pearls on the color coding of eyedrops and then is joined by Salim to discuss ATLS.

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Michael R. -

Sorry for the late comment. Falling a bit behind on my emrap-ing.

In regards to the section on SBP and peripheral pulses, I think the discussion misses a big point....yes peripheral pulses are unreliable. However trauma patients have other physical exam measures to determine perfusion besides a BP. And perfusion is what I'm interested in.

This section doesn't tell me physical exam is unreliable. It tells me that a single physical exam finding should never be taken in isolation.

Michelle Lin, MD -

Hi Michael: Thanks for your comment. I completely agree. The purpose of the ATLS mythbuster segment was to get our trainees from repeatedly making the mistake of using peripheral pulses as a reassurance measure that perfusion is adequate. But your point is well taken. Thanks for commenting!

Paul T. -

I was wondering if there was any way I could get the literature reference for peripheral pulses being unreliable in determining blood pressure? Thanks

Salim R. -

Hello Paul,
The articles are:

1. Guly HR et al Paper: http://www.ncbi.nlm.nih.gov/pubmed/20619954
2. Deakin CD et al Paper: http://www.bmj.com/content/321/7262/673

Hope this helps. :)

Salim

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Episode 145 Full episode audio for MD edition 218:18 min - 103 MB - M4AEM:RAP Resumen October 2013 Español 97:28 min - 67 MB - MP3EM:RAP 2013 October MP3 266 MB - ZIPEM:RAP October 2013 Written Summary 2 MB - PDFEM:RAP October 2013 Board Review Questions 641 KB - PDFEM:RAP October 2013 Board Review Answers 658 KB - PDF

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