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Hypertensive Emergency

A summary of the hypertensive emergency treatment guidelines from: 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines Full Text     PubMed Acute Aortic Dissection Preferred drugs: esmolol, labetalol Reduce SBP to < 120 mm HG within

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Vasopressor Dosing

Epinephrine: Alpha 1+2, Beta 1+2 receptor agonist Increases  inotropy (contraction) and chronotropy (heart rate) Infusion 0.1-1 mcg/kg/min Norepinephrine (Levophed): First line agent for septic shock Strong Alpha 1+2 agonist, mild Beta 1 agonist Minimal chronotropic effects (heart rate increase) Infusion 0.1-5 mcg/kg/min Dopamine: Alpha 1-2 effects at high doses (over 20 mcg/kg/min), Beta 1 effect and NorEpi release. Worsens tachycardia

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VBG vs ABG

Notes: In a meta-analysis, Bloom et al. note that there is good correlation between arterial and venous pH and HCO3. They also concluded that despite variability in arterial and venous pCO2 and lactate, normal venous levels have good negative predictive values. 1 Zeserson et al. studied VBG and SaO2 (pulse oximetery) results in critically ill patients. This population included 41% ED,

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