KellyBracket
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A lot of aspects to this case, but I'll only focus on 1.
This patient presented as a likely CVA with a BP of 220/120. That's an interesting BP in this context.
If you look at the AHA guidelines for ischemic stroke (which you could not have ascertained in the field), lowering the BP is only indicated for a SBP above 220 or DBP above 120. Below that, you have to worry about iatrogenic harm from lowering the cerebral perfusion pressure.
With that in mind, I would avoid making any decisions w/o med con about treating HTN in the field. However, treating pain and nausea are very appropriate.
It's a little bit different when you find out it's hemorrhagic; I'll leave that controversy alone for now!
This patient presented as a likely CVA with a BP of 220/120. That's an interesting BP in this context.
If you look at the AHA guidelines for ischemic stroke (which you could not have ascertained in the field), lowering the BP is only indicated for a SBP above 220 or DBP above 120. Below that, you have to worry about iatrogenic harm from lowering the cerebral perfusion pressure.
With that in mind, I would avoid making any decisions w/o med con about treating HTN in the field. However, treating pain and nausea are very appropriate.
It's a little bit different when you find out it's hemorrhagic; I'll leave that controversy alone for now!
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