Percentage of patients where gaps greater than 10 minutes in blood pressure monitoring are avoided.

The American Society of Anesthesiologist (ASA) standards for basic anesthetic monitoring includes an evaluation of blood pressure at least every five minutes in an effort to ensure adequate circulatory function during anesthesia. A retrospective study including 130,000 general anesthesia cases confirmed that blood pressure gaps greater than six and ten minutes are associated with a higher incidence of a patient transitioning into hypotension, leading to an increased risk of developing kidney or myocardial injury postoperatively. Extenuating circumstances where BP is not quantitatively measured every five minutes should be documented in the patient’s medical record.1-3

Hypotension is strongly associated with mortality, acute kidney injury, and myocardial ischemia.  The avoidance of hypotension requires the timely and frequent measurement of blood pressure.

Intraoperative. See ‘Other Measure Build Details’ for more information.

All patients receiving anesthesia care by an anesthesiology provider, regardless of primary anesthesia technique.

• ASA 5/6 inlcuding Organ Harvest CPT: 01990 
• Diagnostic Procedures (CPT: 01922)
• Procedures:
  • Obstetric Non-Operative Procedures (CPT: 01958)
  • Obstetric Non-Operative Procedures with procedure text Labor Epidural
  • Procedure Type: MRI 

*Cases where the ‘Measure End Time’ precedes ‘Measure Start Time’ will be excluded and marked 'invalid'

Blood pressure monitoring with ≤10-minute gap in measurement interval.

BP 02 measures the avoidance of blood pressure monitoring gaps greater than ten minutes.  Timely blood pressure readings are an essential component of anesthesia vigilance. A measurement gap will be recorded for cases that have greater than ten minutes between consecutive blood pressure readings. The measure will capture non-invasive and invasive BP measurements.

Algorithm for determining Measure Start/End Times:

Measure Start Time:

First Blood Pressure Reading after the latest of these 3 times:

1. First documented Anesthesia Start time.
2. First documented Patient in Room time.
3. First documented Data Capture Start time.

* For labor epidurals which convert to cesarean deliveries where the procedures are combined under one case ID, 'Cesarean Delivery Start Time' is used as the 'Measure Start Time'

Not applicable

Individual signed into case at the 11^th minute of identified measurement gap. Providers signed in for ≤ 10 minutes from the measure start time will be excluded.

1. Standards and Practice Parameters Committee. (2012). American Society of Anesthesiologists. Standards for basic anesthetic monitoring.
2. Kruger GH, Shanks A, Kheterpal S, et al. Influence of non-invasive blood pressure measurement intervals on the occurrence of intra-operative hypotension. Journal of clinical monitoring and computing. 2018;32(4):699-705.
3. Anesthesiologists. ASo. Standards for basic anesthetic monitoring. In: Anesthesiologists ASo, ed. Vol 4.2.22015.
4. Bartels K, Esper SA, Thiele RH. Blood Pressure Monitoring for the Anesthesiologist: A Practical Review. Anesthesia and analgesia. 2016;122(6):1866-1879.