All Emergencies - Basic life support principles:

  1. Maintain an airway
  2. Assess breathing
  3. Monitor circulation
Monitor and record all vital signs.
Treat nausea under sedation as hypotension until proven otherwise.
Hypotension Under Sedation
Signs/symptoms: Definition: Decrease of BP below 30% of patient's guideline.



  1. Check pulse if BP reading questionable
  2. Treat sudden mental status change or nausea as a sign of low BP until proven otherwise
  3. Patient with normal EKG and lower graph indicates pulseoxy plethysmogram- reflects tissue perfusion
  4. Note pulse regularity and oxygen saturation
  5. If EKG shows QRS complex stopped intermittently, there could be a block



  1. If IV is started, administer fluid challenge (IV fluid bolus). Open flow rapidly until blood pressure increases.
  2. If pulse < 60, treat both bradycardia & hypotension with atropine
  3. - 0.5 mg q3-5 minutes x 4, maximum 2.0 mg.
  4. If pulse > 60, treat with ephedrine 10 mg q3-5 min x 5
  5. If hypotension persists, call 911