Texas Health, Rockwall County EMS shine light on hypertension
Oct. 18—Texas Health Hospital Rockwall and Rockwall County EMS are stepping up their efforts to combat high blood pressure — sometimes referred to as the "silent killer" because it can suddenly rise to dangerous levels without causing pain or other symptoms.
Recently, the US Preventive Services Task Force recommended expanding blood pressure screenings during pregnancy. Texas Health and Rockwall County EMS are taking it a step further by working together to quickly identify patients with high blood pressure during pregnancy and in the postpartum period.
For patients who are pregnant, or have recently had a baby, high blood pressure — also called hypertension — can cause life-threatening complications such as stroke, heart failure, kidney failure, seizures and more.
Two changes in procedure have already been made: Paramedic training increased so they can treat high blood pressure and align with hospital treatment regimens while en route to the hospital and all female emergency department patients of childbearing age presenting with high blood pressure are now asked if they've had a baby in the past six weeks.
"Any woman can develop preeclampsia after her baby is born, whether she experienced high blood pressure during her pregnancy or not," said aid Jewell Malick, an OB-GYN on the medical staff at Texas Health Rockwall. "That's why early diagnosis through recognition and proper response to symptoms is crucial. Our goal at the hospital is to administer treatment within 15 minutes of two abnormal blood pressures taken 15 minutes apart."
Texas Health Rockwall care team members and Rockwall County EMS paramedics team up quarterly for training opportunities to run through certain scenarios. Scott Bell, clinical director of Rockwall County EMS says postpartum hypertension is not seen often in the ambulance, but it's a severe condition and imminently dangerous if not treated quickly.
"Our guidelines for treatment have completely changed following our first drill," Bell said. "Previously, we were only identifying and treating patients with a blood pressure reading of 180. We dropped that number down to 160 and now carry medication to treat their blood pressure during a hypertensive crisis."
The 12 weeks after giving birth, also known as the fourth trimester, according to Texas Health, is just as important for a mother's health as the first three trimesters.
This initiative stresses the importance of postpartum follow-up care, rapid recognition and treatment for patients experiencing a hypertensive crisis, said Tami Hlus, chief nursing officer at Texas Health Rockwall.
"Patients who do not have access to regular postpartum follow-up care may not be aware of the signs and symptoms of postpartum preeclampsia or eclampsia," said Jewell Malick, an OB-GYN on the medical staff at Texas Health Rockwall. "We need to educate these patients to promote this critical follow-up care after delivery. This collaboration enables us to be more aggressive in educating and treating patients to improve outcomes."
Before they leave the hospital, Texas Health patients are scheduled for a follow-up appointment and receive information on post-birth warning signs.
Some women have no symptoms of preeclampsia during their pregnancy, which is why it is so important that they get regular check-ups both during pregnancy and after delivery.
"This is an area we all need to be a bit better about, but I think these kinds of interventions and drills are an improvement and a step toward helping decrease pregnancy-related deaths from the condition," Malick said.
