Effects of Methylprednisolone Infusions on Vital Signs in Children With Headaches

OBJECTIVES Intravenous methylprednisolone (IVMP) infusions have been associated with adverse cardiovascular effects. Inconsistent monitoring practices in a pediatric hospital led to questions about patient safety and allocation of nursing resources. This study describes vital sign changes in children and monitoring practices related to IVMP. METHODS This retrospective chart review received Institutional Review Board approval. Children aged 5 to 17 years receiving IVMP from January 2006 to January 2009 were included. Seventy-four patients with 94 hospital admissions were evaluated. Data collected included systolic blood pressure, diastolic blood pressure, and heart rate, as well as the time and dosage of IVMP. Frequency of vital sign monitoring as ordered and as performed was described. Interrater reliability was calculated, and descriptive statistics were used in the data analysis. RESULTS At baseline, about half of the patients had vital signs out of normal range for age. After the first dose, vital sign...