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  • RAP Headache in Adults

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    Saktai Diyami
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    Here is a 1-2 minute handover case summary: This is a 60-year-old male who presented with a 3 hour history of headache and visual disturbances. On examination, he was hypertensive with a blood pressure of 190/120. Given the severity of his hypertension and symptoms of headache and visual changes, this patient is being managed urgently for hypertensive emergency to reduce his blood pressure and prevent end organ damage. He received intravenous antihypertensive medications to lower his blood pressure by no more than 20% and is being closely monitored. Further investigations are being done to assess for any signs of end organ damage such as cardiac, renal or neurological involvement. His blood pressure is gradually coming down with treatment. He will

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    Here is a 1-2 minute handover case summary: This is a 60-year-old male who presented with a 3 hour history of headache and visual disturbances. On examination, he was hypertensive with a blood pressure of 190/120. Given the severity of his hypertension and symptoms of headache and visual changes, this patient is being managed urgently for hypertensive emergency to reduce his blood pressure and prevent end organ damage. He received intravenous antihypertensive medications to lower his blood pressure by no more than 20% and is being closely monitored. Further investigations are being done to assess for any signs of end organ damage such as cardiac, renal or neurological involvement. His blood pressure is gradually coming down with treatment. He will

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
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    18 views25 pages

    RAP Headache in Adults

    Uploaded by

    Saktai Diyami
    Here is a 1-2 minute handover case summary: This is a 60-year-old male who presented with a 3 hour history of headache and visual disturbances. On examination, he was hypertensive with a blood pressure of 190/120. Given the severity of his hypertension and symptoms of headache and visual changes, this patient is being managed urgently for hypertensive emergency to reduce his blood pressure and prevent end organ damage. He received intravenous antihypertensive medications to lower his blood pressure by no more than 20% and is being closely monitored. Further investigations are being done to assess for any signs of end organ damage such as cardiac, renal or neurological involvement. His blood pressure is gradually coming down with treatment. He will

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 25

    Headache in adults

    Rapid Assessment Protocol


    AFEM Keystone Module
    This presentation is part of the African Federation for Emergency Medicine
    Presentation Bank and was developed with open-source materials.

    www.afem.info
    This work is licensed under the Creative Commons Attirbution-
    ShareAlike 4.0 International License. To view a copy of this licence,
    visit http://creativecommons.org/licenses/by-sa/4.0/.
    Case
    • 60 yro male
    • Headache and visual
    disturbance for 3 hrs
    • Vitals: Temp 37.2°C, SPO2
    98%, BP 190/120, RR 22, HR
    105
    Objectives
    • Understand how to use appropriate Rapid Sequence Protocol
    for adults presenting with headache
    Which RAP and why?
    Headache in adults
    IMMEDIATE 0 – 5 min
    • History
    • Physical
    • Diagnostics
    • Therapeutics
    What is your one-sentence case
    summary at 5 minutes?
    EMERGENT 5 – 15 min
    • History
    • Physical
    • Diagnostics
    • Therapeutics
    What is your one-sentence case
    summary at 15 minutes?
    URGENT 15 – 60 min
    • History
    • Physical
    • Diagnostics
    • Therapeutics
    Case
    • 60 yro male
    • Headache and visual
    disturbance for 3 hrs
    • Vitals: Temp 37.2°C, SPO2
    98%, BP 190/120, RR 22, HR
    105
    Severe hypertension
    • Hypertensive Urgency:
    • Severe hypertension without evidence of acute end-organ damage

    • Hypertensive Emergency:
    • Severe hypertension with acute end-organ damage
    Severe hypertension
    • Acute end-organ damage:
    • Cardiac: MI, aortic dissection, pulmonary oedema

    • Renal: AKI, proteinuria

    • Brain: AMS, seizures

    • Placenta: insufficiency, abruptio


    Severe hypertension
    •History:
    • Chronic HPT
    • Medication
    • Stimulant / alcohol use
    • Pregnancy
    • Chest pain
    • Headache
    • Confusion
    • Visual disturbance
    Severe hypertension
    • Examination:
    • CNS

    • CVS

    • Abdomen

    • Fundoscopy
    Severe hypertension

    Management goals:
    Reduce BP
    AND
    Avoid complications
    Severe hypertension
    • Management:

    • No acute damage:
    • BP >200/120: 2 agents, f/u in 1 wk

    • BP >180/110: f/u 1 wk

    • BP >160/100: f/u 1 mnth


    Severe hypertension
    • Management:

    • Acute end-organ damage: reduce BP urgently


    • Mx end-organ damage e.g.: MI, CCF
    • IV agents: aim to reduce BP by maximum of 20%

    • Eclampsia: MgSO4

    • Drugs (cocaine): benzodiazepines

    • Aortic dissection: beta blockers


    What is your final 1 – 2 minute handover
    case summary?

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