If a patient from a motor vehicle crash has no radial pulse, what is the next step?

When a patient from a motor vehicle crash shows no radial pulse, it indicates potential severe circulatory compromise, which may be due to significant blood loss, shock, or cardiac issues. In this scenario, the absence of a radial pulse typically suggests that the blood pressure is critically low, given that the radial pulse is often the first peripheral pulse to be affected by insufficient circulation.

The most appropriate next step is to attempt to find the carotid pulse. The carotid pulse is a central pulse located in the neck, and if present, it indicates that the central circulation is still intact despite the absence of a peripheral pulse. Assessing the carotid pulse can provide critical information about the patient's hemodynamic status and guide further decisions regarding intervention.

Should the carotid pulse also be absent, this would indicate a more severe situation, possibly requiring immediate resuscitative measures. Therefore, checking the carotid pulse is vital in triaging the patient's level of consciousness and need for advanced interventions.