Download Management of hypertension in the ED

Management of
hypertension in the ED
Danielle Nicolo
Problem
• Patients present to ED with hypertension
• Patients treated with medication in ED
• Medicine team comes to admit patient and
blood pressure still elevated
Hypertension refractory to oral meds
or inadequately treated?
•
•
•
•
Safe for floors?
Need ICU?
Medications?
Time?
Solution: ED/IM blood pressure
task force
• Meet with ED and form
interdisciplinary team to form
guidelines to treat hypertension
Solution: ED/IM blood pressure
task force
• Meeting with ED residents and attendings
– Define target patient population: malignant
hypertension
– Identify medications: check inventory
– Formulate treatment plan
Solution: treatment plan
• Request certain oral medications be stocked in
pyxis:
– captopril 25mg
– labetalol 200mg
– hydralazine 25mg
Future directions: treatment plan
• ED residents requested guidelines for using oral
medications
Future directions
• Follow up: Evaluate the effects of changes
• Continue open communication with ED!