Asymptomatic Hypertension

EM Basic

EM Basic LLC

Residency, Student, Medicine, Er, Em, Intern, Health & Fitness, Medical, Education, Emergency

4.6 • 665 Ratings

🗓️ 17 February 2014

⏱️ 23 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

The patient's blood pressure is 190/80 but they feel fine...how do we treat these patients in the ED? Labs? EKG? BP meds? Admission???...but they are here for an ankle sprain! Asymptomatic hypertension is a challenging complaint to deal with in the ED because of so many conflicting opinions and worries but it doesn't have to be difficult. In this episode, we'll discuss a systematic and rational way to evaluate patients with asymptomatic HTN, do limited and targeting testing, and get them the right followup while calming the patient's fears and avoiding harm.

Transcript

Click on a timestamp to play from that location

0:00.0	This is Steve Carroll, and you're listening to the Am Basic podcast. Today we're going to talk
0:05.1	about asymptomatic hypertension. Let's start this episode off with a few situations that you
0:10.3	will run into sooner or later if you work in the emergency department. Dr. Carroll, the patient
0:15.0	with the ankle sprain in bed two is being discharged, but they have a blood pressure of 180 over 90.
0:20.4	Do we need to give her any meds or do you any workup?
0:23.6	The patient in bed 5 was sent in by their dentist because their blood pressure was 200 over 100,
0:28.8	but he feels fine except for that darn tooth.
0:31.9	The patient in bed 6 tells you, I had a headache at home and took my blood pressure and it
0:36.3	was 170 over 90.
0:38.0	Am I going to have a stroke?
0:39.6	And here's the real kicker.
0:41.4	Dr. Carroll, this is the inter-2-clinidate calling.
0:44.4	This guy has been off his BP meds for months.
0:47.3	Can we send them to you for a shot of IV Labelaw while his P.O. Meds kick in?
0:51.4	That one's a true story. Asymptomatic hypertension can be one of the
0:55.6	most confusing topics for any beginner in emergency medicine. This is for a bunch of reasons. Differing
1:01.8	opinions between EM and other specialties about what to do with these patients, the freak out
1:07.0	that occurs when we see impressively high numbers, and the proliferation of the
1:11.6	evil devil machines, also known as home blood pressure monitors. The big questions are,
1:17.2	how high is too high? What do we mean by asymptomatic? Do these patients need testing in the ED?
1:24.2	Do they need admission just because a number on the monitor scares the bejesus out of everyone?
1:29.5	These are all reasonable questions, but there are many differing answers and many subtleties to this.
	...

Please login to see the full transcript.

Previous episode | Next episode

Disclaimer: The podcast and artwork embedded on this page are from EM Basic LLC, and are the property of its owner and not affiliated with or endorsed by Tapesearch.

Generated transcripts are the property of EM Basic LLC and are distributed freely under the Fair Use doctrine. Transcripts generated by Tapesearch are not guaranteed to be accurate.