Emergency Care For Hypertensive Crisis: Algorithm, First Aid

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Emergency care for hypertensive crisis: first aid, how to recognize pathology

The content of the article:

First aid for hypertensive crisis at home
Signs of a hypertensive crisis
Forecast
The reasons
Types of crises
Video

Emergency care for a hypertensive crisis plays an important role. The patient's life may depend on how correctly and quickly it is provided, so you should know the behavior algorithm and signs indicating a crisis.

Emergency care for a sharp increase in blood pressure should be provided as soon as possible

A hypertensive crisis is a sharp increase in blood pressure (BP), which causes a significant deterioration in well-being and can lead to severe damage to vulnerable organs (target organs), that is, those that need a particularly active blood supply. This is one of the most common pathological conditions requiring an ambulance call. Once it has arisen, the crisis tends to recur.

First aid for hypertensive crisis at home

First aid for hypertensive crisis is a set of measures aimed at stabilizing the patient's condition, this assistance must be provided before the arrival of the doctor.

There is an algorithm for emergency care for hypertensive crisis at home. First of all, with a sharp deterioration in the patient's condition and suspicion of a hypertensive crisis, as well as any other vascular pathology, you should call an ambulance without waiting for confirmation of suspicions.

Before the arrival of the ambulance team, the patient must:

Stop physical activity immediately.
Take a semi-sitting position with your legs down or lie down.
Measure blood pressure and pulse, record the results in order to inform medical workers, repeat the measurement every 10-15 minutes.
Provide complete peace, if possible, eliminate bright light, loud sounds.
Provide fresh air by removing tight clothing and opening a window in the room.
If a doctor has previously prescribed medications that he can take in a similar situation, they should be taken.
Take a sedative medicine (tincture of valerian, motherwort, Valocordin, etc.).

If the patient has tachycardia (accelerated heart rate), you can massage the carotid sinuses. To do this, it is necessary to massage or rub the neck from both sides in the places of pulsation of the carotid arteries for 10-15 minutes.

Attention! In case of a hypertensive crisis, it is unacceptable:

drink alcohol;
exceed the dose of medications prescribed by the doctor, reduce blood pressure too quickly (the decrease in blood pressure should not exceed 25% of the initial level for 2-3 hours);
hide from the doctor the causes of the hypertensive crisis (the use of alcoholic beverages, drugs, severe stress), the number and names of drugs taken, as well as the patient's diseases;
take any food within the first hours from the onset of the attack.

When a hypertensive crisis develops for the first time, the patient is usually shown emergency hospitalization for detailed diagnosis and treatment. The tactics of a paramedic and / or an ambulance doctor, as well as the choice of a particular treatment regimen for a hypertensive crisis, depend on the cause of its development and the existing symptoms (type of crisis). So, to normalize blood pressure after an attack, the patient can be prescribed diuretic, hypotensive, antispasmodic and other drugs. In severe cases, measures are taken to maintain the vital functions of the body.

Before the ambulance arrives, you need to measure your blood pressure several times

The actions of the nurse are important in the treatment and monitoring of the patient. The nurse monitors the patient's condition in the hospital department, fulfills the doctor's prescriptions, advises the patient on issues that fall within her sphere of competence.

Signs of a hypertensive crisis

A hypertensive crisis usually occurs with prolonged arterial hypertension, but it can also appear with normal blood pressure. If a person has symptoms that suggest the development of a hypertensive crisis, regardless of the presence or absence of arterial hypertension in the anamnesis, you should immediately seek medical help.

Signs of a hypertensive crisis include:

intense headache of a pressing, bursting, sometimes pulsating character, localized in the occipital region, temples, behind the eyes, or not having a clear localization;
hyperemia of the face;
feeling of heat, sometimes there is a rush of heat to the head, while the limbs, on the contrary, become cold;
excessive sweating;
nausea and vomiting, which are not associated with food intake and depend on the headache;
flashing of flies before the eyes, darkening in the eyes;
feeling short of breath, shortness of breath;
compressive pain in the region of the heart and behind the sternum;
acceleration of heart rate (more than 90 beats per minute);
agitation, anxiety, panic attack (associated with increased production of adrenaline).

The appearance of drowsiness, weakness, impaired articulation, staggering gait, disorientation during a hypertensive crisis indicates insufficient cerebral circulation and the risk of stroke. A jump in blood pressure in a hypertensive crisis can cause cerebral hemorrhage, cerebral edema, glaucoma, vision loss, atrial fibrillation, myocardial infarction, pulmonary edema, seizures, kidney damage and a number of other complications.

Forecast

The prognosis for hypertensive crisis depends on the patient's age (younger patients usually tolerate it more easily), damage to target organs (heart, brain, kidneys), timeliness and adequacy of medical care.

With a complicated hypertensive crisis with damage to target organs, the development of severe life-threatening conditions, disability and death is possible. In the case of acute disturbance of cerebral circulation and cerebral edema against the background of a hypertensive crisis, death occurs in about 35% of cases.

The factors that worsen the prognosis in a hypertensive crisis and increase the risk of adverse consequences include smoking, alcoholism, overweight, a tendency to thrombosis, diabetes mellitus, and chronic diseases of the cardiovascular system.

The prognosis often depends on the timeliness of medical care.

The reasons

In about 60% of cases, the disease occurs against the background of prolonged and uncontrolled arterial hypertension, so it usually occurs in patients in the 30-60 age group who are most susceptible to hypertension, but it can also occur in children, for example, with kidney disease.

The main risk factors include frequent stress, physical stress, bad habits, a sharp change in the scheme (or cancellation) of taking antihypertensive drugs, uncontrolled intake of drugs (especially in combination with the use of tonic drinks), osteochondrosis (violation of cerebral circulation is caused by compression of blood vessels by the cervical vertebrae), endocrine disorders, diseases of the cardiovascular and central nervous system.

Types of crises

Currently, there is no single standard for the classification of hypertensive crises. Crisis is distinguished as complicated and uncomplicated; clinicians also speak of hypertensive crises of types 1 and 2:

type 1 hypertensive crisis - as a rule, it develops in young patients in the early stages of hypertension, occurs suddenly, often against a background of stress, has a short-term course, complications rarely occur;
type 2 hypertensive crisis - usually observed in elderly people in the late stages of hypertension, develops gradually, can last 4-5 days, complications often develop.

In addition, a hypertensive crisis is classified according to the type of blood pressure increase (systolic, diastolic and mixed), according to the type of hemodynamic disturbance (hypokinetic, hyperkinetic, eukinetic).

First aid for hypertensive crisis is provided without taking into account these features, but they are important for the development of therapeutic tactics.