Incidents
ER24 paramedics can play a vital role in stabilising hypertensive patients, preventing catastrophic complications like stroke, heart attack, or kidney failure.
What is a hypertensive crisis?
A hypertensive crisis occurs when your blood pressure rises to dangerously high levels, usually above 180/120mmHg. At this point, the pressure places significant strain on the heart, brain, and other vital organs.
“In these situations, ER24 paramedics play a key role in recognising the level of severity early, initiating appropriate care, and making sure the patient is transported to the right hospital,” says Leslie-Anne van Zyl, an Emergency Care Practitioner at ER24 Southern Cape. “This helps reduce the risk of serious complications such as stroke, heart attack, and organ damage.”
There are two types of hypertensive crisis, she explains. “In some cases, blood pressure is severely elevated but there’s no immediate evidence of organ damage. In other cases, the high blood pressure has already started to affect organs such as your brain, heart, or kidneys.”
However, both situations are considered medical emergencies. “Even when there’s no immediate organ damage, persistent high blood pressure can progress and lead to organ injury if it’s not treated in time.”
Never ignore these warning signs
A hypertensive crisis doesn’t always cause clear symptoms, so it can be missed until complications occur. Some people may feel unwell, while others may have little or no symptoms, even when their blood pressure is dangerously high.
When symptoms do appear, they may include:
- Severe or ongoing headache that may come and go in intensity
- Changes in vision, such as blurred vision or brief vision loss
- Chest pain or tightness
- Signs related to the brain, such as confusion, trouble speaking, weakness on one side of the body, or drowsiness and reduced awareness.
How ER24 paramedics manage a hypertensive crisis
“The ER24 paramedics focus on early recognition, close monitoring, and ensuring the patient receives the correct level of care as quickly as possible,” Van Zyl explains.
Assessment begins by confirming blood pressure readings and performing a full clinical check to look for warning signs, such as changes in brain function, chest pain, or other symptoms that suggest the condition is affecting the patient’s body.
Ongoing monitoring is important, including repeated vital signs and heart monitoring when needed.
Oxygen is only given if it is medically necessary, for example, if oxygen levels are low. It is not used in every case.
In more serious cases, an intravenous (IV) line may be placed to administer medication under medical guidance if needed.
Blood pressure is managed carefully in the pre-hospital setting. The aim is not to lower it quickly, but to monitor the patient closely, provide supportive care, and arrange safe transfer to hospital when required. If there are signs of a possible stroke or other serious complications, the hospital is alerted in advance so the team can prepare for immediate treatment on arrival.
Overall, the focus is on keeping the patient stable, preventing their condition from worsening, and getting them to the right level of care as quickly and safely as possible.
When to call ER24
Call 084 124 for immediate medical assistance if you or someone else experiences:
- Blood pressure that is significantly higher than your normal, or a reading above 180/120mmHg
- Severe or persistent headache, especially if unusual
- Changes in vision, such as blurred or loss of vision
- Chest pain or discomfort
- Confusion, difficulty speaking, or sudden weakness.
If you’re unsure, it’s always best to seek medical help early – don’t wait for symptoms to get worse.
Prevention: your best defence
While emergency care is essential in a hypertensive crisis, prevention remains key. “Take prescribed blood pressure medication as directed, monitor your blood pressure regularly, and attend routine medical check-ups,” advises Van Zyl.
“Maintaining a healthy lifestyle, including a balanced diet, regular exercise, limiting alcohol intake, and avoiding smoking, can go a long way in reducing your risk.”