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Initiation of Invasive Arterial Pressure Monitoring by Critical Care Transport Crews

Published:December 25, 2021DOI:https://doi.org/10.1016/j.amj.2021.11.006

      Highlights

      • Noninvasive blood pressure monitoring is inaccurate, especially in critically ill patients.
      • Numerous therapeutic patient interventions are based on accurate blood pressure parameters.
      • Prehospital paramedics, nurses, and physicians should strongly consider the use of invasive arterial pressure monitoring, especially during critical care transport.
      • Radial artery cannulation for invasive arterial pressure monitoring is, in general, a safe and effective procedure that might reasonably be performed in the prehospital setting by both physicians and nonphysicians.

      Abstract

      Noninvasive blood pressure monitoring is convenient in the prehospital setting, but its use in the critically ill patient should be carefully considered given documented inaccuracies. Countless therapeutic patient interventions are based on blood pressure parameters, and the prehospital paramedic, nurse, and physician should strongly consider the use of invasive blood pressure monitoring, especially during critical care transport. Radial artery cannulation for arterial blood pressure monitoring is a safe and effective procedure that can reasonably be performed in the prehospital setting by both physicians and nonphysicians. Critical care transport teams should consider clinical guidelines that outline indications and training to safely implement this as a clinical skill.
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