A discussion of the etiologies, evaluation, and management of acute hypertension that develops in a patient already hospitalized. #InternCrashCourse #FOAMed #MedEd
Пікірлер: 32
@mariapelepciuc5197 Жыл бұрын
Why so underrated ???? This is just what we need. Nobody ever explained like this dif diagnosis ❤ more videos please
@smasher248 Жыл бұрын
It's very esoteric content
@agd712 Жыл бұрын
The Patagonia fleece comment killed me haha. Too real. Your best series yet!
@StrongMed Жыл бұрын
I tried to get DALLE-E 2 to create a picture of a resident in scrubs and a fleece vest for the video, but despite using up all my free attempts this month for it, it didn't understand "vest" or "fleece" in the context of a doctor. That's why this video doesn't have a picture of a doc like the others in the series. ¯\_(ツ)_/¯
@adlesal24 Жыл бұрын
I became addicted to this type of series. I cannot miss any episode ❤
@chrisguapo6911 ай бұрын
as a rapid response nurse, this is great content!
@DannyMercer1993 Жыл бұрын
Exceptional series!!!! Don’t stop haha 🎉
@pulamusumali258 Жыл бұрын
This is simply the best unmatched world over am from Zambia and I watch him always
@niketshah95 Жыл бұрын
Absolutely loving the rapid response series!!
@jonathanking3223 Жыл бұрын
Thank you. See this a lot as an acp working AIM. Probably would have added endocrine as another cause category to cover things like pheo and conns. Element of bias though as currently waiting adrenalectomy for conns myself!!
@phillipwalter899324 күн бұрын
Excellent
@twistedtea7046 Жыл бұрын
A great video elaboration of the “no evidence just stop!” article written in Today’s hospitalist some time back
@nieklennethjobuban52516 ай бұрын
Learned a lot🎉
@gobindknowledgeofeverythin1681 Жыл бұрын
Beautiful lecture lot of love from India
@anilkarameti484 Жыл бұрын
You're doing a great job with these videos doc, helping students and MD's. Doctor, what do you think about the new guidelines that consider the numbers 130/80 to be first stage hypertension? Do you agree with that and do you think those numbers should be lowered in healthy individuals? Also, what do you think is the best medicine to give on an hypertensive emrgency caused by severe anxiety?
@StrongMed Жыл бұрын
I don't have a particularly strong opinion on redefining hypertension as >=130/80 (as recommended by the ACC/AHA in 2017), though my understanding is that it was largely based on the results of the SPRINT trial, which IMHO was significantly methodologically flawed. Interestingly, the influential American Academy of Family Physicians did not change their own recommendations on hypertension in 2017 - partially for the same reasons that I'm skeptical of it. In addition, guidelines and individual clinicians alike don't necessary make a distinction between a BP high enough to label "hypertension", a BP high enough to prescribe an anti-hypertensive med, and the BP goal for a patient on anti-hypertensives. Those three numbers are not necessarily the same. Also, BP goals should be individualized, and no one should be too dogmatic about something which is an ever-changing *guideline* rather than a rule that must be followed. The best medication to give to patient during a hypertensive emergency caused by severe anxiety is probably a benzodiazepine - in most cases.
@Macicek2011 Жыл бұрын
This is such a valuable topic, and yes hydralazine is evil, especially if continued on the outpatient basis. So many of my patients get switched from their regular antihypertensives to hydralazine in the hospital. They are discharged on TID hydralazine and I have to deal with it....
@StrongMed Жыл бұрын
This is the worst!
@areufkingkiddingme Жыл бұрын
I love hydralazine
@juliachambers725 Жыл бұрын
Thank you
@kgrfirdjy Жыл бұрын
thanks for the review. i have been on either side of the bed on this, having had HTN since I was 8, & as an emergency nurse, realizing this is scary. Working as part of a team diagnosing // treating the underlying cause can be challenging, being far more than administering sublingual nitroglycerin, iv lasix, or iv labetalol.
@MarmalardАй бұрын
You’re also limited by what can be given on the floor at a given hospital. My hospital has no problem with IV hydralazine but anything like labetalol or iv nitro they’ll need to be in ICU.
@StrongMedАй бұрын
At a previous hospital where I worked, IV beta blockers could be given on the floor but only if a doctor was physically present at the bedside when they went in. For every single dose. But as soon as the med was in the vein, the doc could leave (i.e. even before onset of action). Such a dumb policy!
@youngace6482 Жыл бұрын
You are awesome❤
@giorgiog.4025 Жыл бұрын
Thank you Dr. Strong for the extremely valuable educational resource. Just a question... how do you lower BP of a specific percentage? In other words, once you choose the drug, how do you choose the dose to aim for a 20% reduction in 1h?
@StrongMed Жыл бұрын
It's 1/3 personal experience, 1/3 advice from more experienced colleagues, and 1/3 guess. And remember, you can always give more anti-hypertensive, but you can't take it back once given. (i.e. err on the side of underdosing the patient but with frequent reassessment)
@giorgiog.4025 Жыл бұрын
@@StrongMed Thank you very much
@drsohailzahir28379 ай бұрын
❤❤❤
@samadmaqsood1514 Жыл бұрын
Are there any lectures notes on the “How to approach different symptoms “ series
@ghadeernajim310 Жыл бұрын
Thank you for another great video again🔥 Doc there is something I would like to ask : Do you know any resources ( textbook , websites ) that describe in details the exact practical informations and steps in our practice in internal medicine and emergency medicine because for example when I studied shock in a high-rated and well recognized book for emergency medicine it did not mention practical points like shock index or fluid calculation by using shock percent until I found these informations accidentally on internet websites. So please if you can recommend any resources that would provide sufficient practical knowledge I would be thankful .
@StrongMed Жыл бұрын
I definitely don't know of any textbooks. For other resources, I don't know if this is precisely what you mean, but I think the Rational Clinical Exam series in JAMA and Things We Do For No Reason in the Journal of Hospital Medicine are both great - though the latter is more of the opposite of what you are asking for (i.e. practical things that we do, but which he shouldn't!)