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Pulse rate over pressure evaluation (ROPE) is useful in the assessment of compensated haemorrhagic shock
M W Ardagh1, T Hodgson, L Shaw
1Emergency Department, Christchurch School of Medicine, Christchurch Hospital, New Zealand. michaela@chh1th.govt.nz
Objective:
To evaluate a calculation of pulse rate over pulse pressure as a method of predicting decompensation in patients with compensated haemorrhagic shock.
Methods:
A retrospective cohort study was undertaken enrolling 184 adult victims of major road trauma who were not shocked on presentation to the emergency department. A pulse rate over pressure evaluation was calculated at presentation and vital signs were observed during the first 2 h of emergency department management.
Results:
Thirty-one patients became shocked during their first 2 h. A ROPE value of greater than 3.0 had a positive predictive value of 53% and a value less than 3.0 had a negative predictive value of 86% for the development of decompensated shock.
Conclusions:
ROPE is an easily applied and useful clinical tool with a ROPE of less than 3.0 being predictive of a patient remaining well and a ROPE of above 3.0 being predictive of the patient developing decompensated shock.