•You are working on the medicine service in the hospital. You’ve had a stelar performance and have shown excellent growth over the last few weeks.
•Jonathon Dough came into the hospital today with a hemorrhagic stroke. Multiple services are on the case and you have started the medical consult for the team.
•You are sitting at the nurse’s station and familiarizing yourself with the details of the case. Just then, Dr. Gruncle Stan, the neurosurgeon, comes out of the patient’s room and updates the nurse. He tells her that there are no surgical plans for the patient, and that medicine (meaning you) needs to work on the blood pressure.
•You want to finish this rotation strong, do your best for the patient, (and not incur the wrath of a neurosurgeon)… but you don’t know anything about brain bleeds (beyond that a surgeon should be on the case).
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•Mr. Dough currently has a systolic blood pressure of 200, and neurosurgery hinted that something needs to be done.
•You decide to check the guidelines for… guidance.
•You find guidelines from the AHA/ASA
•American Heart Association
•American Stroke Association
•(These two groups seem like reliable resources for this investigation)
•Specifically:
•2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage
•Go to the guidelines and look for recommendations on blood pressure
•ProTip: Tables, figures, flowcharts, graphs, etc., in a guideline are great spots for high-yield information
•Remember you are allowed to use Ctrl+F to search
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•What is a reasonable systolic blood pressure for Mr. Dough
•A) SBP ~200 (leave it alone)
•B) SBP 130-150
•C) SBP 100-120
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