A patient under general anesthesia shows an abrupt fall in blood pressure. What should be done FIRST?

Correct answer: B. Confirm the reading — check the cuff position, size and connections

• A. ❌ Compressions are indicated for a patient with no pulse — the scenario describes hypotension, not arrest.
• B. ✅ CORRECT — Before treating a number, confirm the number is real. A sudden isolated drop with a stable patient is very often ARTEFACT: a cuff that has slipped, a wrong cuff size, a kinked line, or a limb that has been moved. Verify the reading and check the patient (pulse, colour, capnography) simultaneously.
• C. ❌ Deepening the anesthetic would worsen genuine hypotension; anesthetic agents are themselves vasodilators and myocardial depressants.
• D. ❌ Epinephrine for a possibly artefactual reading could produce dangerous hypertension and arrhythmia.

Note: If the reading is real: stop the precipitant, give oxygen, position the patient supine with legs elevated, run fluids, then consider vasopressors.