How Does Hypertension/High Blood Pressure Concern A EMT Basic? Shock/Nitro Treatment? What Else?

Can everyone shoot me ideas of what hypertension has to do with EMT Basic assements and stuff. When is it important? Why does it help to know what it is?

As an EMT Basic, your treatment of HTN really isn't going to be extensive. You're only authorized to give the patient his or her own nitroglycerin as a treatment for chest pain. As a EMT-Paramedic, you can give the patient nitro for HTN, in addition to other drugs (the availability of other drugs depends on which state you work in). Even in a restrictive state like Alabama, I can give nitroglycerin for HTN when the patient has possible organ damage issues.

As an EMT Basic, identifying HTN is important. It's pretty common for the average patient to be slightly hypertensive. I don't really blink unless the systolic is above 150, and the diastolic is 100 or above. Sometimes, a patient can be hypertensive from stress or pain. Calming the patient down, splinting fractures (so they are less painful), and keeping the patient comfortable can help in reducing blood pressure. Don't forget about oxygen therapy. It also can help calm the patient down (when you put a patient on oxygen, they feel like you are actually doing something to help them).

When you have a very hypertensive patient, they are at increased risk of having a CVA or a brain bleed (that's never a good thing!). Take notice if they are having a headache, blurred vision, changes in mental status, or shortness of breath, and be sure to tell the ALS intercept or the hospital of their symptoms.

Other things to consider are if the patient is suspected of having an acute stroke. Generally, you don't want to treat HTN in this instance, because that high blood pressure is actually helping to keep the brain perfused.

If they are a trauma patient, and a closed head injury is suspected, then watch out for bradycardia and hypertension, along with altered mental status and changes in respiration. Those symptoms point to a closed head trauma.

I checked the New York State protocols (only ones I could quickly find online) and they recommend that an EMT Basic apply oxygen, and if certified, start an IV. They also mentioned (and I thought this was pretty important) that true hypertensive crisises are quite rare, and not to overlook the possibility that the patient's symptoms are from another cause.

Hope this helps :-)