Blood Pressure Management Goals in Stroke Care

Blood pressure management goals in stroke care You arrive at a small rural emergency healthcare facility to transport a 72-year-old female who presents to the ED with the worst headache of her life. She’s to be transported to a tertiary center with neurosurgical services. Upon further questioning you determine her headache was sudden onset with maximum intensity. When reviewing her history and medications, you note that she’s currently on Coumadin (warfarin) with an international normalized ratio (INR) of 3.5, with the following vital signs noted on the monitor upon entering the room: blood pressure of 209/75 mmHg; heart rate of 66; respiratory rate of 16; SpO2 of 98% on a nasal cannula at 2 Lpm. The facility’s staff report a substantial decline in the patient’s level of consciousness since her arrival with a current Glasgow coma scale of 11. You review the CT of her head and note blood in the sulci, confirming the diagnosis of subarachnoid hemorrhage. You and your partner discuss management strategies to maximize the patient’s outcome during the hour-long transport. During interfacility transports where the type of stroke is known, you’ll often have very different blood pressure goals depending on if the stroke was identified as ischemic or hemorrhagic. Blood Pressure Goals: Clot Vs. Bleed Hypertension is a common problem afflicting all races and genders worldwide.1 In many circumstances, hypertension is often over-treated, in both the hospital and prehospital ...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Patient Care Cardiac & Resuscitation Source Type: news