The order of first aid for hypertensive crisis

1 What is the

? The hypertensive crisis( hypertensive crisis, GK) is an acute emergency that occurs against the background of high blood pressure, characterized by a sudden and sharp jump to individually high figures. The emergence of a crisis often contributes to a stressful situation or an extreme situation.

Diagnosis of the crisis is based, first, on the dynamics of changes in blood pressure indicators for the previous period, and secondly, on the basis of the patient's well-being. At the slightest suspicion of a crisis, it must be remembered that it requires immediate relief and a controlled reduction in pressure to prevent the defeat of so-called target organs. Target organs are primarily the brain and nervous system, as well as the eyes, kidneys, heart and blood vessels, so urgent care for hypertensive crisis should be given immediately and to the maximum extent.

The risk of hypertensive crisis is that it entails the risk of severe cardiovascular and nervous system disorders such as heart attack, acute heart failure, stroke or subarachnoid hemorrhage, encephalopathy, kidney and vision damage, cerebral edema orlungs. Therefore, the basic theoretical knowledge of how emergency care is provided in hypertensive crisis is necessary for everyone in the modern world, where cardiovascular diseases have become much more frequent and "younger".

2 Risk factors for

The following causes may be the prerequisites for the onset of a hypertensive crisis:

• genetic predisposition;
• weak, unstable nervous system, the presence of neuroses, obsessive conditions, increased anxiety, etc., aggravated by stress or psychotraumatic situations;
• endocrine( hormonal) diseases, such as diabetes mellitus, thyroid dysfunction, obesity;in women, the risk increases during the menopause or premenstrual period;
• chronic diseases in the stage of exacerbation, especially vascular disease, kidney, cervical osteochondrosis;
• alcohol abuse, excessively salty food, leading to water-salt imbalance in the body, smoking, taking psychoactive substances;
• abrupt withdrawal or irregular intake of medically prescribed drugs that lower blood pressure;
• sharp changes in atmospheric pressure, jumps in weather and geomagnetic background, to which the vessels do not have time to adapt.

Any of the above factors can already independently, alone provoke a crisis, and if there are several, you need to be extremely careful and closely monitor the condition of the body.

4 Action has not yet arrived the ambulance

First aid for a hypertensive crisis consists in the immediate adoption of the next set of measures.

1. Provide patient with a state of complete rest. It is contraindicated to walk and show any physical activity, you need to put it in a comfortable semi-sitting position with the help of pillows. If the attack occurred on the street, you need to put under his back coiled clothes and other improvised means. The head should always be above the body level to prevent increased blood flow and reduce stress on the vessels of the brain.
2. Reduce the brightness of lighting near the patient and, if possible, ensure maximum silence and the absence of external stimuli. The environment should behave calmly and not give in to panic, as nervousness is instantly transmitted to the patient.
3. As the crisis makes breathing difficult, it is necessary to unbutton tight clothes, relax the collar, scarf, tie, etc.
4. A cooling compress, a heating pad or an ice pack should be applied to the patient's head.
5. Legs of the affected, on the contrary, need to be warmed well: attach a heating pad, a plastic bottle with hot water, you can put on the calf muscles mustard.
6. To clarify the patient, whether he suffers from high blood pressure, what medications are prescribed to him by a doctor to reduce it, and give him this medicine. If the ambulance does not arrive within an hour, and the pressure does not decrease, the drug should be repeated, but it must be monitored so as not to lower the pressure too much - this can trigger a loss of consciousness and further complicate the patient's condition, especially in the elderly.
7. If it is not possible to give the patient his usual medication or if he did not take antihypertensive medications at all, he can be given a Nifedipine tablet( but only if he does not have severe tachycardia, angina and heart disease).The drug effectively reduces blood pressure, its effect lasts 4-5 hours, during which time the doctor will have time to examine the patient and prescribe him individual treatment. In the presence of heart disease or information on intolerance to the patient Nifedipina, the drug can be replaced by Captopril - it normalizes blood pressure, protects the heart and prevents the development of nephropathy. In addition, unlike Nifedipine, captopril does not cause drowsiness, dizziness and tachycardia, but it only lasts about 1 hour and is contraindicated in kidney diseases. If both drugs are contraindicated, or none has had the desired effect, then doctors recommend intravenous administration of a 25% solution of magnesium sulfate, but this already refers more to qualified medical care than to pre-medical.
8. It is advisable to give the patient 20 drops of Corvalolum to relieve anxiety, panic and fear of death, which usually cover a person in a state of hypertensive crisis. Instead corvalol suitable valokordin, tincture of valerian or motherwort.
9. For cardiac pain, give the patient a validol or nitroglycerin, but the latter must be used very carefully: it dilates the blood vessels and can provoke a collapse in a hypokinetic-type crisis( with a slight increase in pressure).
10. With a very violent headache that indicates an increase in intracranial pressure, you can give a pill of the diuretic drug Furosemide.
11. If the patient is in the room, then you need to provide him with fresh air, but it is important to ensure that he does not catch a cold.
12. If possible, monitor blood pressure, record the tonometer, heart rate and breathing every 5-15 minutes before the arrival of the doctor.

If the patient is alone in the room and does not have the opportunity to call for help, he must call an ambulance, take an antihypertensive drug and open the locks of the entrance doors, so that the medical team can get into the apartment if it gets worse.

In the home and working first-aid kit, you should keep the necessary drugs in case of a hypertensive crisis, even if you do not have obvious problems with blood pressure. However, when providing pre-hospital care for hypertensive crisis, the main thing is not to aggravate the patient's condition even more, so taking any medications should be done with the utmost care. In no case should the dosages indicated in the instructions be exceeded.

The success of the management of the hypertensive crisis and a favorable prognosis for the treatment of its consequences depends largely on clear and competent actions for the provision of pre-hospital care. Please, be attentive to others and do not leave a person who has the above described clinical picture in trouble, since he can not be able to cope with this state on his own.

3 Characteristics of

Symptomatic of hypertensive crisis also has individual characteristics for each patient. In some cases, only high blood pressure is observed without a pronounced clinical picture( hyperkinetic type of crisis) or, conversely, pressure within the upper limit of the norm, but with all the characteristic clinical symptoms( hypokinetic type).

The most characteristic symptoms are the following:

• attack of severe headache, especially in the occipital region;
• dizziness, tinnitus, problems with breathing, reflexes and coordination of movements;
• general strong excitation of the nervous system, or, on the contrary, excessive lethargy, apathy and drowsiness;
• severe sweating;
• dry mouth;
• tremor of the limbs;
• severe nausea with vomiting, which does not bring relief;
• increased heart rate, a sense of unmotivated fear, anxiety, panic attacks;
• sensation of pulsation in the temples;
• edema and hyperemia( reddening) of the skin in the head and upper body;
• very often painful phenomena in the chest compressive nature;
• high blood pressure, especially diastolic.

The presence of any of these symptoms, and especially their complex, requires an urgent emergency call. This is the signal to start providing emergency first-aid measures.

Independently to stop the hypertensive crisis without appropriate medical preparation is impossible! Improper medical care can lead to a stroke or a heart attack. Appeal to a doctor in this situation is strictly necessary.