Hypertensive Emergency — Neurological

SBP reduction 10–20% first hour

First 30 seconds

  1. 1ABCDE, arterial line
  2. 2NIH stroke scale, GCS, glucose
  3. 3Urgent CT brain

BP ≥180/120 with acute neurological end-organ damage (encephalopathy, ischaemic/haemorrhagic stroke, SAH).

A

Airway

  • • Patency, protect
  • • Adjuncts / definitive airway
B

Breathing

  • • RR, SpO₂
  • • O₂ to target sats
C

Circulation

  • • HR, BP, IV access
  • • Fluids/vasopressors
D

Disability

  • • AVPU/GCS, pupils, glucose
E

Exposure

  • • Full exposure, bleeding, source
View flowchart algorithm

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Clinical Decisions in Seconds