BLOOD PRESSURE TARGETS IN THE ED Subarachnoid SBP < 140-160 ‘Treat hypertension to prevent r-bloed raised ICP: MAP > 80 Need ta balance thi goa uth maintaining Hemorrtiage a jequate CPP (allowing MAP fo be >B0). Consider withinoding antHTN if ther is severe impakment in LOC since this impatment could be de to reduced CPP ‘Spontaneous ICH SBP < 140-180 “reat hypertension to reduce risk of raised ICP: MAP > 80 rebleeding and hematoma expansion. Consider higher-end of target if baseline HIN. Lower more aggressively if initial SBP > 220, Spec age sl conroveri Acute Ischemic Stroke: Before TPA: High BP increases risk of hemorrhagic TPA Candidate ‘SBP < 185, DBP < 110 conversion postysis. — For 24 hours after TPA: Se ‘SBP < 180, DBP < 105 Acute Ischemic Stroke: If SBP >220 or DBP > 120: ‘Only need to treat blood pressure if very Not TPA Candidate | BP by 18% over 24 hours —_levated. Avoid rapid lowering of blood re because be might worsen a. Higher blood pressure mina a Hypertensive | BP by 20% in first hour Headache, NIV, Confusion. Symptoms Encephalopathy tues when BP has lowered, Diagnosis Frat ne fr neuro relaed HT: Labetao Near, Avo vasedlating agents (nrogyee.nteprussdo) be hey crease carota blood Vand 1 Hemorrhagic Shock Can tolerate lower BP No specific cut-off defined. (SBP>70-90, MAP>65) Controlled resuscitation (formerly known 2s, permission hypotension). Avoid excessive ids to minimize hemedition, Nui overload, tot disruption from higher BP. Be coutous if: eery, uncontrolled baseline HTN, neurogenic shock, major head injury. Neurogenic Shock MAP > 85 Maintain BP to ensure adequate bood flow tothe spinal cor Start pressors ear if arget not met ater adminsterng blaos products Traumatic Brain Injury Age 50-69: SBP > 100 Want CPP 50-60. Low BP means low ‘Age <50, 704: SBP> 110 | cutralparusion. These are he iim * MAP > cut Lee caterer I BP is very high (200): reat pain. IfBP very high (>200): Treat pain 8 reompeing pete: slot whats retest teat if to determine the age Aortic Dissection HR < 60 “Treat pain fist with fentanyl SBP < 110 Reduce sheaing ores,