Hypertensive crisis (HC) is a state manifested by high blood pressure (systolic “upper”, usually more than 180 mm Hg; diastolic “lower”, more than 120 mm Hg). ) and the following symptoms: headache, more often in the occipital region, or heaviness and noise in the head; glimpse of “flies”, swaddling or netting in front of the eyes; nausea, a feeling of brokenness, fatigue, internal tension; shortness of breath, weakness, constant monotonous aching pains/discomfort in the heart region; the appearance or growth of pasty / edema of the face, hands, legs.
First aid activities
When symptoms of hypertensive crisis appear, it is necessary:
- Remove the bright light, provide peace, access to fresh air (unbutton the gate shirt, air the room, etc.).
- Measure blood pressure, and if its “upper” level is higher or equal to 160 mm Hg, you should take a hypotensive drug previously recommended by a doctor. If there is no hypotensive drug recommended by a doctor or if the blood pressure level is above 200 mmHg, you must urgently call an ambulance.
- Before the arrival of the ambulance should, if possible, sit in a chair with armrests and take a hot foot bath (lower legs in a container with hot water). Attention! A patient with a hypertensive crisis is prohibited any sudden movements (get up sharply, sits down, lie down, bend, push) and any physical activity.
- In 40-60 minutes after taking the medicine recommended by the doctor, it is necessary to measure the BP again, and if its level has not decreased by 20-30 mm Hg from the initial one and/or the condition has not improved – call an ambulance immediately.
- If you are feeling better and your blood pressure has decreased, you should rest (go to bed with a raised headboard) and after that go to the local (family) doctor.
When talking to a doctor, it is necessary to clarify what drugs you need to take in the development of hypertension crisis, clearly record their names, dosage and temporal sequence (algorithm) of their reception, as well as clarify with the doctor, in what manifestations of the disease you need to urgently call an ambulance.
All patients with hypertension need to form an individual mini-aid kit for first aid in case of hypertensive crisis and carry it with you all the time, as hypertensive crisis can develop at any time and in any place.
Measuring blood pressure
In order to diagnose a hypertensive crisis, it is necessary to measure the blood pressure, which is performed manually using a stethoscope (stethophonendoscope) and a special inflatable cuff equipped with a pear pump and sphygmomanometer, as well as an automatic (semi-automatic) method using various models of tonometers specially designed for this purpose.
The accuracy of BP measurement and, consequently, the guarantee of correct diagnosis and the degree of severity of the hypertensive crisis depend on compliance with the rules for its measurement.
The measurement should be carried out sitting on the back of a chair, with relaxed and unbound legs, the hand rests on a table at heart level, in a relaxed environment, after a 5-minute rest. During the measurement, you should not actively move or talk. In special cases, BP measurement can be performed while lying down or standing.
The cuff is superimposed on the shoulder, its lower edge 2 cm above the elbow bend. The size of the cuff should correspond to the size of the arm: the rubber inflatable part of the cuff should cover at least 80% of the shoulder circumference; for adults, a cuff 12-13 cm wide and 30-35 cm long (medium size) is used; it is necessary to have a large and small cuff for full and thin hands respectively.
The mercury column or sphygmomanometer arrow must be at the zero mark and in front of the researcher’s eyes before measurement.