Beware of Even a Single Hypotensive Blood Pressure Measurement in Trauma Patients

A single systolic BP reading <105 mm Hg in the emergency department portends serious injury and the potential need for immediate surgical or endovascular intervention.

Hypotension in trauma patients typically occurs after loss of 30% of total blood and, if persistent, can lead to end-organ injury resulting from hypoperfusion and uncompensated shock. In a prospective observational study at a single level I trauma center, researchers determined the systolic blood pressure (SBP) cutpoint value that best predicts the need for therapeutic surgical or endovascular procedures; 145 adult patients (77% men; 54% with blunt mechanism of injury) who had at least one SBP measurement <110 mm Hg during initial trauma care were enrolled during a 6-month period. Exclusion criteria were transfer from another hospital, injury more than 2 hours before emergency department (ED) arrival, and isolated prehospital hypotension (<…

Reviewing Author

John A. Marx, MD, FAAEM