Round 23 (High Blood Pressure)


Case Introduction

You are working a shift at EM Clerkship General when you are handed the next chart, a 60 year old male presenting with high blood pressure.

Initial Vitals

  • Temp 98.0F
  • HR 90
  • RR 18
  • BP 220/120
  • O2 98%

Critical Actions

  • Perform thorough neurological exam (and find papilledema)
  • Diagnose Hypertensive Emergency
  • Start anti-hypertensive drip (usually Nicardipene)
  • Recheck patient’s blood pressure after intervention
  • Admit to ICU

Further Reading

Hypertensive Emergency (EMCrit)


  1. Ingrid Cohen

    Oh my goodness the progress Mike has made is incredible!!!!! Today’s episode/round had me reflecting on the growth!

    Thank you to both of you, I love this podcast. It’s bittersweet to see Mike grow so much. I never want this podcast to stop! Maybe we can recruit the show a new resident if Mike continues to crush each case.

    Thank you. Thank you.

    • Mike Estephan

      I appreciate the kind words :). I still have so much to learn and I’m sure Zack will continue to find ways to throw me for a loop (like episode 22 with the resuscitative hysterotomy and neonatal resuscitation). Thanks for listening!

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