Quote from caldje
Without more information I cant honestly say the doc isnt doing what he's supposed to. We have to remember that there are many things we dont know. For example, the vast majority of hypertension is not sensitive to salt intake AND low sodium can actually increase the risk of renal complications when on certain meds. Like I said, a full case presentation of this patient, leaving nothing out, and I think we might find that the doc is not being "bad."
Dangerously high BP is all the clinical information I need to know. This has been going on for a week. What more info does this doc need? What if this were your elderly Dad/Mom? I'd be having a fit. I would have already taken them to the ER after the first severely elevated set of orthostatics and fired the doctor.
Give the guy a break, you wouldnt want someone treating you like you're treating him.
Just how am I treating him badly? I followed his order to keep him informed of the BP's. I wasn't rude in any way. I asked if the pt needed to come in or go to the ER. My concern was for my patient. I never treated the doctor badly. The fact that I think he's totally incompetent is something he'll never hear from me. I know my limits.
Lets review the basics of hypertension:
HTN is the silent killer... high blood pressure left uncontrolled, causes fatal heart attacks, sudden cardiac death and strokes. If you have high blood pressure, the increased pressure of blood flowing through your arteries can cause a variety of problems, including arteriosclerosis, an aneurysm, kidney failure, damage to the heart such as coronary artery disease, heart failure and an enlarged left heart. Just like your heart, your brain depends on a nourishing blood supply to function properly and survive. High blood pressure can cause several problems, including: Brain bleed, transient ischemic attacks, dementia due to the extensive narrowing of the arteries that supply blood to the brain. The kidneys are responsible for filtering and excreting excess fluid and waste from the blood. These processes are highly dependent on blood vessels. HTN compromises both the vessels leading in and out of the kidneys. HTN is the leading cause of kidney failure.
HTN damages the eyes. The tiny delicate blood vessels that supply blood to the eyes are vulnerable to the damage of high blood pressure.
In some patients the blood pressure rises so quickly and severely that it constitutes a medical emergency requiring immediate treatment.