Excellent, excellent presentation and my practice pattern completely. I have unfortunately fought with patients families and nurses over these points too many times. The patient is often caught in the middle, feeling fine and wants to go home but poorly informed advocates are extremely concerned and sometimes need their own blood pressures checked.
Thirty some years ago as a 35 year old I went to the ER for something unrelated to my blood pressure. It was 220/130 but I felt fine. The doctors gave me an oral anti hypertensive drug and I waited maybe 2 hours. It was still high. I received another dose and after another hour my bp was the same. The doctor released me but called me a few days later to make sure I was ok, which I was. About 15 years later I was diagnosed with high bp at 150/100 after three doctor visits. I am 71 now and my bp stayed at 130/80 on amlodopine and olmesartan until I lost 95 pounds. The last 20 pounds lost plus high intensity circuits have brought it down to 110/70 where it is today. I feel the same as I did when it was 220/130 but I am very glad it is well controlled as my father had a stroke and a heart attack and my mother had vascular dementia.
I’m not a fan of making it MY responsibility to make sure a patient has follow up. If it was I’d be calling everyone’s pcp . At some point it’s the patient that needs to take personal responsibility to make the appointment
@@m5073 to clarify my post, I did see a doctor after this ER visit and my blood pressure was fine until several years later. I merely posted my experience to illustrate how my blood pressure crisis was handled in this case. I thought it was very professional and caring for the doctor to call me as a follow up to my ER visit. That’s all…
Tough for me to reconcile not getting an EKG, UA, and BMP on a pt with a systolic over 180. How else to access for end organ damage in these tissues? If present, that would most definitely change management or am I missing something?
Do you think asymptomatic elevated blood pressure only happens at the ED? Or rather the patient has been walking around with that BP for a while and you just happened to detect it now. Should we go around taking random EKGs to people then? This is completely asymptomatic elevated BP.
Excellent, excellent presentation and my practice pattern completely. I have unfortunately fought with patients families and nurses over these points too many times. The patient is often caught in the middle, feeling fine and wants to go home but poorly informed advocates are extremely concerned and sometimes need their own blood pressures checked.
Thirty some years ago as a 35 year old I went to the ER for something unrelated to my blood pressure. It was 220/130 but I felt fine. The doctors gave me an oral anti hypertensive drug and I waited maybe 2 hours. It was still high. I received another dose and after another hour my bp was the same. The doctor released me but called me a few days later to make sure I was ok, which I was. About 15 years later I was diagnosed with high bp at 150/100 after three doctor visits. I am 71 now and my bp stayed at 130/80 on amlodopine and olmesartan until I lost 95 pounds. The last 20 pounds lost plus high intensity circuits have brought it down to 110/70 where it is today. I feel the same as I did when it was 220/130 but I am very glad it is well controlled as my father had a stroke and a heart attack and my mother had vascular dementia.
Amazing care and follow-up. Good for you. Thanks for sharing.
I’m not a fan of making it MY responsibility to make sure a patient has follow up. If it was I’d be calling everyone’s pcp . At some point it’s the patient that needs to take personal responsibility to make the appointment
@@m5073 to clarify my post, I did see a doctor after this ER visit and my blood pressure was fine until several years later. I merely posted my experience to illustrate how my blood pressure crisis was handled in this case. I thought it was very professional and caring for the doctor to call me as a follow up to my ER visit. That’s all…
Tough for me to reconcile not getting an EKG, UA, and BMP on a pt with a systolic over 180. How else to access for end organ damage in these tissues? If present, that would most definitely change management or am I missing something?
Yeah, an EKG especially is nothing. Everyone deserves an ekg haha
Do you think asymptomatic elevated blood pressure only happens at the ED? Or rather the patient has been walking around with that BP for a while and you just happened to detect it now. Should we go around taking random EKGs to people then?
This is completely asymptomatic elevated BP.
Great presentation. You're hilarious, Dr Bontempo 😄
Preach!!