high systolic very low diastolic

[captainstandup]

One of the earlier posts had already mentioned the most important consideration for this patient is stability. Is the patient having chest pain, shortness of breath, pulmonary edema and the most importantly what is the patients LOC? If the LOC is normal the brain is being perfused and the patients condition is likely stable for the moment.

As I eluded to in my earlier post in this thread, the specific cause for an aberrant BP is quite complex and can include poor heart valve function secondary to stenosis, a condition known as left ventricular hypertrophy, akinetic heart tissue in a specific portion of the heart following an MI. Anyway, most of this stuff is related to in hospital care and clearly requires a cath lab, echo and lab studies to diagnose. Having a high index of suspicion regarding potential for decompensation is crucial. This patient may only require BLS care during transport, but being prepared for the worst is always prudent. This is especially true when you have unusual vital signs or simply a "feeling" that something is wrong. I think it speaks highly of your your quality as a prehospital provider that you did not simply overlook or "blow off" this unusual blood pressure reading. I have two favorite sayings, 1)Chance favors the prepared mind 2)True knowledge lies in "knowing the why".

Good job and keep on asking "the why"

[Richard B the EMT]

I keep telling people that only 2 things affect blood pressure: Anything and Everything!

While I say that with intent towards humor, I have had people with readings of "whatever"/zero, some with complaints, others without. I play it by ear, on a case by case basis, using S/S for guidance as how to proceed from that point.