Noninvasive Blood Pressure Monitoring and Electrocardiography

There is a lack of data about the benefits of cardiovascular monitoring with continuous 3-lead electrocardiography (ECG) and intermittent noninvasive cuff blood pressure (BP) during procedural sedation and analgesia (PSA) in the pediatric population. However, these two safe modalities are important for patients during higher levels of PSA because of the risk of rare life-threatening conditions and to help identify possible medication side effects and drug interactions of common sedative medications. These monitoring modalities can also aid in determining the adequacy of sedation. It is generally accepted that a baseline determination of heart rate and BP should be obtained prior to any sedative administration. With deeper levels of sedation and throughout recovery, continuous 3-lead ECG and intermittent BP monitoring are recommended, in addition to other modalities such as pulse oximetry and capnography, to monitor the safety of the patient.