Patients who had incomplete ED records, required invasive mechanical ventilation, or had no pain throughout their ED stay were excluded. We included non-trauma adult ED patients who were interhospital-transferred and underwent operative interventions within 12 hours of ICU arrival between July 2013 and June 2014. Methods: This was a retrospective study at a single, quaternary referral, academic medical center. We hypothesized that patients who were interhospital-transferred from an ED to an intensive care unit (ICU) for urgent surgical interventions would display objective pathology for pain and thus receive adequate pain management at ED departure. Patients who had objective findings of long bone fractures were more likely to receive pain medication than those who did not, despite pain complaints. Reasons for poor pain management include providers’ concerns for drug-seeking behaviors and perceptions of patients’ complaints. Introduction: Pain is the most common complaint for an emergency department (ED) visit, but ED pain management is poor. Further studies are needed to confirm our observations and investigate the benefits vs the risk of harm of IABP monitoring in patients with sepsis. Additionally, higher SOFA score and serum lactate were associated with higher likelihood of clinically significant blood pressure discrepancy. There were no complications (95% CI: 0-0.02) from arterial catheter insertions.Ĭonclusion: Among our population of septic patients, the use of vasopressors was associated with increased odds of a clinically significant blood pressure discrepancy between IABP and NIBP measurement. In multivariable logistic regression, higher Sequential Organ Failure Assessment (SOFA) score (OR 1.33 95% CI: 1.02-1.73 P = 0.03) and serum lactate (OR 1.27 95% CI: 1.003-1.60, P = 0.04) were associated with increased likelihood of clinically significant BPD. Among 57 (45%) requiring vasopressors, 9 (16%) patients had a clinically significant BPD vs 2 patients (3% odds ratio 6.4 95% CI: 1.2-30 P = 0.01) without vasopressors. We defined a clinically significant BP discrepancy (BPD) between NIBP and IABP measurement as a difference of > 10 millimeters of mercury (mm Hg) AND change of BP management to maintain mean arterial pressure ≥ 65 mm Hg. We included patients with sepsis conditions AND IABP monitoring. Methods: We performed a retrospective study of adult patients admitted to the critical care resuscitation unit at a quaternary medical center between January 1–December 31, 2017. We hypothesized that IABP monitoring would be associated with changes in management among patients with sepsis requiring vasopressors. This study investigated discrepancies between IABP and NIBP measurement and their clinical significance. The Surviving Sepsis Guidelines recommend invasive arterial BP (IABP) monitoring, although the benefits over non-invasive BP (NIBP) monitoring are unclear. Introduction: Blood pressure (BP) monitoring is an essential component of sepsis management.
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