April 7, 2021

Take Home Points
  • Altered mental status has numerous possible etiologies. Splitting it into vital sign issues, toxic/metabolic, infectious processes, CNS issues (bleed, mass) and psych/dementia is a good way to organize your thoughts
  • Hypertensive encephalopathy is a diagnosis of exclusion - make sure you're not dealing with another process like meningitis or an intracranial hemorrhage
  • Once the diagnosis of hypertensive encephalopathy is made, shoot to lower the SBP by about 20-25% over the hour using a drug like nicardipine, clevidipine or labetalol

July 21, 2014

As emergency physicians, we are constantly on the look out for elevated blood pressures and the potential devastating consequences. We are concerned about intracranial bleeds and acute pulmonary edema from heart failure. But what about the patient that comes in with high blood pressures, yet has no symptoms? Do we need to treat the number or the patient? In this post we will tackle this clinical dilemma of elevated asymptomatic hypertension: To treat or not to treat?
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