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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!