Defining the Problem
A severely elevated blood pressure becomes an emergency when it is accompanied by symptoms of end-organ damage such as severe headache, chest pain, confusion, visual changes, seizures, or shortness of breath.
Assessment
Take multiple readings and compare them with the patient's baseline. Ask about missed medications, stimulant use, and recent events. Look for signs of stroke, cardiac ischemia, and pulmonary edema.
Care
Position the patient comfortably, administer oxygen if needed, and keep the environment calm. EMTs do not lower blood pressure with medication, so transport promptly and communicate findings to the receiving facility.