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Medgeeks with Andrew Reid

Hypertensive Urgency - Say no to the ER!

Medgeeks with Andrew Reid

Medgeeks

Medicine, Health & Fitness, Education

4.8996 Ratings

🗓️ 29 March 2017

⏱️ 15 minutes

🧾️ Download transcript

Summary

We're going to walk through urgency vs emergency. In other words, do we need to admit or can we treat as an outpatient? We'll go over the symptoms, physical exam, and lab testing needed to help us differentiate between the two. Then, we'll go over the management for these patients!

Don't send everyone with a high blood pressure to the ED!

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Transcript

Click on a timestamp to play from that location

0:00.0

What is going on? Today we're going to be talking hyper-tensive urgency. Now a

0:06.3

disclaimer for today's episode we're going to be talking about the non-pregnant

0:10.6

patient. This discussion is going to

0:13.0

on hypertensive urgency and the non-pregnant patient.

0:17.0

Now, hypertensive urgency, let's get right into the material here,

0:22.0

and hypertensive urgency is simply a severely elevated blood pressure

0:27.5

without an organ damage.

0:29.0

And this is where a lot of people go wrong.

0:30.7

A lot of people go wrong because they start to look at the numbers and the numbers

0:34.5

don't necessarily matter all that much. What really matters here is if we have an organ damage.

0:41.7

It doesn't matter how high systolic, how high dystolic is. Now typically, for the most part,

0:46.6

we're looking at urgency when we have a systolic over 180 and a diastolic over 120.

0:52.8

And typically, again, we're looking at

0:55.2

hypertensive emergencies when we have a systolic over 200

0:59.3

over 220.

1:00.2

However, remember, the main differentiating factor between a urgency and emergency is simply

1:07.8

and organ damage.

1:09.4

So just to make this point very, very clear, if we have a systolic blood pressure right a

1:16.4

systolic blood pressure of let's say one seventy

1:21.6

however we have end organ damage that that is still considered a hypertensive emergency.

1:26.6

It's the end organ damage that matters, not necessarily the blood pressure numbers themselves.

1:32.0

So let's get right into the discussion with

...

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