During a procedure under general anesthesia the patient's blood pressure begins to drop abruptly. What is the FIRST thing to do?

Correct answer: A. Verify the reading — check the cuff placement, size, and monitor connection

• A. CORRECT. ARTIFACT is a far more common cause of a sudden isolated monitor change than a true catastrophic event. Confirm the reading first: correct cuff size and placement, no leaks or kinks, and cross-check against clinical signs — pulse quality, capnography, oxygen saturation, skin colour, and heart rate. This takes seconds and prevents an inappropriate and potentially harmful intervention. If the reading is confirmed and the patient is genuinely hypotensive, then reduce anesthetic depth, give fluids, and consider a vasopressor.
• B. Chest compressions are indicated only for cardiac arrest — a patient with a pulse must not receive them.
• C. Giving a vasopressor for an unconfirmed reading is dangerous.
• D. Abruptly discontinuing anesthesia mid-procedure is not the first step and could produce awareness, laryngospasm, or an uncontrolled airway.

Note: Emergency principle: treat the PATIENT, not the monitor. Always correlate a monitor alarm with clinical assessment before intervening.