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    Asymptomatic Elevated Blood Pressure (beta)

    Official guideline from the American College of Emergency Physicians.

    Summary by Eric Steinberg, DO
    Strength
    Level A
    Level B
    Level C

    Risk Stratification and Intervention

    Risk Stratification
    1. In emergency department (ED) patients with asymptomatic markedly elevated blood pressure, routine screening for acute target organ injury (eg, serum creatinine, urinalysis, electrocardiogram [ECG]) is not required.
    2. In select patient populations (eg, poor follow-up), screening for an elevated serum creatinine level may identify kidney injury that affects disposition (eg, hospital admission).
    Intervention
    1. In patients with asymptomatic markedly elevated blood pressure, routine emergency department (ED) medical intervention is not required.
    2. In select patient populations (eg, poor follow-up), emergency physicians may treat markedly elevated blood pressure in the emergency department (ED) and/or initiate therapy for long-term control. [Consensus recommendation]
    3. Patients with asymptomatic markedly elevated blood pressure should be referred for outpatient follow-up. [Consensus recommendation]
    What do the icons mean?  
    Research PaperWolf SJ, Lo B, Shih RD, et al. American College of Emergency Physicians. Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients in the Emergency Department With Asymptomatic Elevated Blood Pressure. Ann Emerg Med. 2013;62(1):59-68.