First aid at hypertensive crisis

Hypertensive crisis – the acute state which is characterized by sharp rise in the arterial pressure (AP), posing direct threat to life. Therefore it is important to know signs of this state and to be able to give first aid at hypertensive crisis.

It is normal of value of an indicator of the ABP also at crisis

In spite of the fact that raising of the ABP is also the reason of hypertensive crisis, there is no accurate quantitative index of the ABP which would indicate that the events hypertensive crisis, but not something other. For this reason doctors recommend to patients to know with cardiovascular and renal pathology (namely such patients first of all enter into risk group) the, so-called, working pressure – indicators of the ABP which correspond to their normal health in lack of an emotional and exercise stress.

This parameter at people can differ as the norm of the ABP fluctuates in quite considerable limits – from 110 to 140 mm Hg for a systolic (upper) indicator, and from 60 to 90 mm Hg for diastolic (lower). For most of the people who do not have a hypertension norm is the indicator of the systolic pressure of 110 mm Hg, respectively, increase in pressure even to 120 mm Hg can testify to pathology while for the person inclined to a hypertension, the indicator in 140 mm Hg can be norm.

If the patient knows the working pressure, then, making a start from it, it is possible to define the state which is hypertensive crisis or menacing to them to become. For example, if to usual health of the person there corresponds pressure of 110/70 mm Hg, then the indicator in 120/80 will already indicate a hypertension.

It must be kept in mind that not each person with hypertensive crisis knows the working pressure, the victim cannot sometimes give the correct answer during the occurring crisis because of feeling sick, but also, not always the tonometer is had near at hand to measure the ABP. Therefore for first-aid treatment it is necessary to know also other symptoms of hypertensive crisis.

Symptoms of hypertensive crisis

Symptoms of hypertensive crisis are:

• The sharp or amplifying headache, it is especially frequent in occipital area;
• Feeling of squeezing of the head;
• Feeling of a pulsation of blood in temples;
• Reddening or on the contrary, blanching of integuments;
• Ring in ears;
• Eye pain, "front sights" before eyes, deterioration in sight;
• Emergence of an asthma, pain behind a breast and tachycardia (cardiopalmus) is possible;
• Nausea, is possible vomiting;
• Acrimony, sharp reaction to bright light, loud sounds and other activators.

Hypertensive crisis can sharply develop, and can gradually, with slow increase of symptoms. The first type of crisis is called hyperkinetic, it is inherent to people at early stages of a hypertension. Not too high rates of the ABP are characteristic of this type, in addition to the acute beginning. The second type is called hypokinetic, as a rule, it happens at the people long ago having a hypertension, the ABP at the same time raises considerably, and symptoms of crisis can remain from several hours to several days. Both types can lead to effects extremely hazardous to health, up to a lethal outcome.

First-aid treatment at hypertensive crisis

The first that needs to be made at suspicion of hypertensive crisis, it to call the ambulance. The before people will receive the qualified help, rather it will be possible to stop an attack and the less risk of development of heavy complications of crisis.

In this rule there is an exception. Many patients, it is long having a hypertension, are already able to stop crisis, distinguishing its approach on the first symptoms and taking necessary medicine on the algorithm made by the attending physician. In this case, having accepted necessary drugs, the person has to remain all the same under observation, and having only convinced that drugs worked, and the condition of the victim improves, it is possible to refuse a call of acute management. Nevertheless, it is necessary to inform on the event of the attending physician in the nearest future.

In all other cases waiting for arrival of ambulance it is necessary to do the following:

1. To lay the patient with the raised head. If the headache in a prone position amplifies, it is possible to reach a comfortable sitting position;
2. To provide to the patient absolute rest, both physical, and emotional;
3. To provide inflow of fresh air: to open a window, to weaken close clothes;
4. If circumstances allow, to carry out the procedures directed to blood outflow: to put cold to the head, to apply mustard plasters to a collar zone, gastrocnemius muscles. It is possible to make a hot foot tray.

Giving first aid at hypertensive crisis it is important to remember that, despite an intensive headache, the patient before arrival of ambulance should not give any drugs "from the head", "from heart", etc. which by accident were available and in operation which you are not sure. The anesthetizing drugs are undesirable as they complicate the subsequent diagnosis, without removing the crisis causes. But even if it is known that the drug which accidentally appeared near at hand possesses anti-hypertensive (lowering pressure) action, it must be kept in mind - in such situation the doctor as too sharp decrease in the ABP at hypertensive crisis can also lead to serious consequences has to appoint and control drug treatment.