humbty
Forum Elite
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In this question there is a woman with a typical history of worst headache ever (SAH). Her blood pressure is very high 240/130.
Question is: what is the first step in management.
I thought CT without contrast to make the diagnosis first
their answer is lower BP with iv nitroprusside.
Is that only the case if a patient with a history consistent with SAH has a very high BP? And if yes, are their any guidelines at which BP one should first lower blood pressure before obtaining CT? Or should one always start lowering BP before CT (of course only if its elevated). I thought one should first confirm the diagnosis before starting treatment.
Thank you in advance!
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| humbty
Forum Elite
Topics: 24
Posts: 135
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ah sorry, one correction: the question was what is the next step in mgmt. She also has some nuchal rigidity on PE and is nauseous and lethargic. NO focal neurologic signs.
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| drhyd
Forum Senior
Topics: 7
Posts: 82
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Hi
it is htn emergency, so first lower BP. its above 210/110.so give iv nitrorusside.
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| humbty
Forum Elite
Topics: 24
Posts: 135
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ok thanks so if its below 210/110 i first order the ct?
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| drhyd
Forum Senior
Topics: 7
Posts: 82
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Hi humbty please check wether this question also contains any end organ damage.
thank u
drhyd
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