If the pt is otherwise stable (no s/sx hypertensive emergency or urgency), treatment to control the BP really is in the best interest of both the pt AND the Rad: no bleeding from angio site, overall DECREASED COMPLICATIONS if BP is controlled! IMHO Rads do tend to be exclusively procedure-focussed; however, they are not the pt's primary MD (and don't wanna be!). I agree with you: that BP must be relatively controlled during and after the case. See if you can get some parameters, meds and dosages from the Anesthesiologists/CRNAs - THEY are OUR wellspring of wisdom! I too have been chewed by the PACU for pt with high BP; and if the PACU nurse calls the Rad, he'll just refer them to the primary MD, who, by the way, is not always the referring MD for the procedure/angio, so you play guessing games for whom to call, and then play phone and beeper tag. Meanwhile, the pt's BP continues . . . As you probably have seen, the elevated BP can be directly related to anxiety R/T procedure; Versed etc help sometimes, not all the time. I've had anesthesiologists say they'd cancel a case if the BP was XXX/XXX. However, a lot of our cases are slightly more urgent than just an elective surgery, and benefit VS risk must be weighed when considering whether to postpone a case . . .
How would this work: Gather your info then write a proposed policy and present it to the Rads (all or just the Chief Rad), with the pt's well-being and the potential for complication prevention as the primary focus. Our Rads seem to respond well if we do all the groundwork/writing, the policy is sensible, and they have only to OK a it (and it's been developed in conjunction with their "peers", the Anesthesiologists).
Re: "meds on hand"; do you use a Pyxis system or have to get the meds from the Pharmacy each time? Before Pyxis we had a supply of emergency meds we kept in the angio room: Priscoline, Tridil, antiemetics, antihypertensives, steroids, Epi and Benadryl for contrast reactions, as well as Lidocaine, Atropine, Dextrose 50%, and others that we could access quickly in a Radiologic or ANY emergency (as well as a crash cart nearby). Each X-ray room in the dept where contrast is injected still has a small locked box (checked and maintained by the Pharmacy personnel) with emergency drugs for severe contrast reactions. NO DELAYS IN TREATMENT = IMPROVED OUTCOMES. (not to mention the nurses breathe easier knowing the meds are at hand)
Good luck to you! I'm interested to know what you do and what happens. -- D