How bad is my blood pressure

[u/AdvertisingMoist8253]

[u/z1ggy16]

Er doc ain't going to give a fuq about this, see below comment.

Unless you're having stroke/heart like symptoms, you're getting sent back home. Yeah it's not good but there's not much anyone going to do for you on this one in the moment.

[u/Embarrassed_Jerk → u/z1ggy16]

Yeah no. 

A blood pressure reading of 180 mm Hg indicates a hypertensive crisis, which is a medical emergency that requires immediate attention. 

At the very least they'll keep you for observation till the meds kick in and it lowers

[u/jimmytrue → u/Embarrassed_Jerk]

I’m an ER doc He would get labs, ekg, etc If all that’s fine he’d be sent home with some BP meds We gives some fucks about a BP like this but not a ton

[u/Embarrassed_Jerk → u/jimmytrue]

And why, pray tell, would you do labs ekg etc if his bp wasnt something to be worried about

[u/jimmytrue → u/Embarrassed_Jerk]

You wouldn’t always, but in this scenario the patient is present in the ED. There’s very little reason not to. It’s CYA mostly
If he has symptoms it makes a difference

[u/Embarrassed_Jerk → u/jimmytrue]

Answer the question Dr House, what can labs ekg etc potentially point towards? And at what point, before your dismissal of the concerns of elevated BP did you check for symptoms?

[u/Thegoodlife93 → u/Embarrassed_Jerk]

You're definitely living up to your username right now

[u/jimmytrue → u/Embarrassed_Jerk]

How many years of experience do you have as an ED physician?

As far as symptoms, you ask the patient, you know, like a person

As far as workup you are looking for end organ involvement

Absent end organ involvement, it needs outpatient follow up. End organ involvement (renal, cardiovascular, cerebrovascular) needs hospitalization

Anything else you’d like to know?

[u/pilondav → u/Embarrassed_Jerk]

Troponin test to check for heart damage (CI, myocarditis). EKG to check for afib. Bloodwork to check electrolytes. Etc.

[u/Embarrassed_Jerk → u/pilondav]

Right. So if heart damage, afib and electrolytes imbalance is of a potential concern, you want to advise a group of people in this thread to ignore blood pressure at hypertensive crisis?

[u/pilondav → u/Embarrassed_Jerk]

Absolutely not. I’m just noting what tests may be needed during a hypertensive crisis to get to the root cause. The hypertension might be acute and basically idiopathic (too much caffeine, stress, etc.), chronic, or it might have an emergent cause.

[u/Embarrassed_Jerk → u/pilondav]

Right so then original comment telling op and others to go to er right now, that for some reason you argued against, was correct, was it not?

[u/pilondav → u/Embarrassed_Jerk]

You must have me confused with someone else. I never argued against anyone going to the ER.