A blood pressure reading noted as “70 over palp” refers to a specific method of measuring a person’s circulatory force, which can appear confusing because it lacks the expected second number. This notation provides a systolic pressure of 70 millimeters of mercury (mmHg), followed by the abbreviation “palp,” short for palpation. Understanding this measurement requires knowing how standard blood pressure is usually taken and why a healthcare provider might use a less common, tactile method. The use of “palp” signals that the provider only obtained the top number by feeling for the return of a pulse.
Standard Blood Pressure Measurement
Blood pressure is routinely measured as a pair of numbers, such as 120/80 mmHg, representing two distinct phases of the cardiac cycle. The first, higher number is the systolic pressure, reflecting the maximum force exerted on the artery walls when the heart contracts and pushes blood out. The second, lower number is the diastolic pressure, which measures the minimum force against the artery walls when the heart relaxes and refills with blood. The standard method for obtaining both values is auscultation, which involves using a stethoscope to listen for specific sounds, known as Korotkoff sounds, as the pressure cuff deflates.
The Palpation Technique for Systolic Pressure
The palpation technique determines blood pressure using touch, rather than hearing the Korotkoff sounds with a stethoscope. A healthcare provider applies a blood pressure cuff to the upper arm and locates a pulse point, most commonly the radial pulse at the wrist. The cuff is inflated until the pressure completely stops the blood flow, and the radial pulse can no longer be felt. The provider then slowly releases the pressure while continuously feeling the radial artery. The moment the pulse is first felt to return is recorded as the systolic blood pressure, and it is marked with the “palp” notation to indicate the method used.
Interpreting a Palpated Reading
The reading “70 over palp” means the patient’s systolic pressure was measured at 70 mmHg using the palpation method. The absence of a second number signifies that diastolic pressure was not, and cannot be, obtained by this technique. The palpation method relies on feeling the mechanical return of a pulse wave, which is only strong enough to be detected at the peak pressure of the heart’s contraction. Diastolic pressure, which occurs when the artery is fully open and blood flow is steady, does not create the turbulent pulse wave required for tactile detection. The technique is therefore limited to providing only the systolic value.
This method is often employed in situations where using a stethoscope is difficult, such as in noisy emergency environments or in a moving ambulance. It is also used when a patient’s blood pressure is severely low, known as hypotension, because the faint pulse sounds can be impossible to hear, but the return of the pulse can still be felt.
A systolic reading of 70 mmHg is significantly lower than the normal range and suggests a state of severe hypotension, indicating a potential circulatory compromise. In such critical situations, quickly establishing the minimum required systolic pressure for organ perfusion is the immediate goal, making the palpated systolic reading an immediately useful piece of information. The “palp” designation is a clear communication to other medical professionals that the patient’s condition required this rapid, specialized assessment method.