{
  "schemaVersion": 2,
  "eyebrow": "Emergency Medicine",
  "title": "Hypertensive Emergency",
  "summary": "Hypertensive emergency requires immediate recognition of acute target-organ injury, but the supplied sources do not provide condition-specific diagnostic thresholds, treatment targets, or antihypertensive dosing. Management should therefore follow current local and specialty guidance rather than unsupported protocolization.",
  "seoDescription": "Point-of-care overview of hypertensive emergency emphasizing recognition of acute target-organ injury and evidence limitations in the supplied literature.",
  "clinicalQuestion": "How should physicians distinguish hypertensive emergency from severe asymptomatic hypertension and initiate evidence-based acute management?",
  "specialty": "Emergency Medicine",
  "audience": "U.S. physicians and medical trainees",
  "tags": [
    "hypertensive emergency",
    "acute severe hypertension",
    "target-organ injury",
    "emergency department hypertension"
  ],
  "keyTakeaways": [
    "Do not equate a markedly elevated blood pressure measurement alone with hypertensive emergency; the clinically decisive issue is acute target-organ injury. Condition-specific criteria are not supplied in the retrieved literature.",
    "The supplied evidence set contains no current hypertension guideline, FDA labeling, or trial report supporting a specific intravenous antihypertensive agent, dose, blood-pressure reduction target, or monitoring interval.",
    "Emergency-care guidelines often rest on lower-level evidence: in one review, 50.4% of recommendations in current ACEP clinical policies were Level C equivalent and 59.9% of their cited evidence was Class III equivalent. [17]",
    "Clinical guidelines affecting emergency medicine should supplement care with emergency physician oversight and do not themselves define the emergency medicine standard of care. [20]"
  ],
  "sections": [
    {
      "id": "clinical-priority",
      "eyebrow": "Immediate decision",
      "heading": "Confirm acute target-organ injury before labeling hypertensive emergency",
      "intro": "The supplied sources do not provide a validated diagnostic pathway for this condition.",
      "paragraphs": [
        "For a patient with severe blood-pressure elevation, the operational distinction between hypertensive emergency and severe asymptomatic hypertension depends on whether acute injury is present in a vulnerable target organ. However, none of the supplied sources provides condition-specific clinical criteria, laboratory thresholds, imaging indications, or diagnostic test performance for hypertensive emergency. Avoid using an unsupported blood-pressure cutoff as a stand-alone diagnosis.",
        "The immediate evaluation should therefore be directed by the presenting syndrome and examination findings rather than by blood pressure alone. Use current institutional pathways and contemporary disease-specific guidance for suspected neurologic, cardiovascular, renal, retinal, or aortic injury; these resources were not included in the supplied evidence set."
      ],
      "bullets": [],
      "subsections": [],
      "table": {
        "caption": "",
        "columns": [],
        "rows": []
      }
    },
    {
      "id": "treatment-limitations",
      "eyebrow": "Management",
      "heading": "Use syndrome-specific treatment guidance rather than unsupported drug protocols",
      "intro": "No medication regimen can be responsibly specified from the available sources.",
      "paragraphs": [
        "The supplied search results do not contain a contemporary U.S. guideline, FDA prescribing information, pharmacology reference, or pivotal treatment trial for hypertensive emergency. Consequently, they do not support naming a preferred intravenous agent, route, starting dose, titration schedule, blood-pressure target, rate of reduction, contraindication, or renal/hepatic adjustment.",
        "This absence matters because drug selection and blood-pressure reduction goals vary with the end-organ syndrome and because overly rapid reduction can create ischemic risk. Obtain immediate specialty input when acute neurologic, coronary, aortic, pulmonary edema, renal, pregnancy-related, or other organ-specific pathology is suspected; use locally approved order sets only after confirming they are current."
      ],
      "bullets": [
        "Document the suspected target-organ syndrome, blood-pressure measurement method, repeat measurements, neurologic and cardiovascular findings, and the rationale for escalation or disposition.",
        "Do not infer dosing from broad emergency medicine medication-safety literature; the retrieved dosing-related sources do not address antihypertensive treatment for hypertensive emergency. [5][12][13]"
      ],
      "subsections": [],
      "table": {
        "caption": "",
        "columns": [],
        "rows": []
      }
    },
    {
      "id": "implementation-and-evidence",
      "eyebrow": "Quality and implementation",
      "heading": "Treat protocols as decision support, not substitutes for clinical judgment",
      "intro": "Protocol quality, accessibility, and evidence strength materially affect bedside use.",
      "paragraphs": [
        "A systematic review of ACEP clinical policies found that only 9.2% of recommendations in current policies were Level A equivalent, while 50.4% were Level C equivalent; 59.9% of graded cited evidence was Class III equivalent. [17] This does not invalidate individual recommendations, but it supports identifying the evidence basis and applicability of any local hypertensive-emergency pathway before treating it as definitive.",
        "In an appraisal of 20 ACEP clinical policies, applicability received the lowest mean AGREE II domain score (35%), despite relatively high scores for scope and purpose, rigor of development, and clarity of presentation. [18] Local pathways should therefore explicitly identify implementation requirements, ownership, revision dates, and circumstances requiring deviation or consultation.",
        "ACEP states that guidelines affecting emergency medicine should supplement and enhance care under emergency physician oversight and do not represent the standard of care. [20] For hypertensive emergency, this is especially relevant when a patient’s syndrome, comorbidity, or treatment response falls outside a simplified algorithm."
      ],
      "bullets": [
        "Assign clinical ownership and a review date for institutional pathways.",
        "Use concise, standardized, accessible workflow design, but preserve links to the underlying evidence and full protocol. [19]",
        "Audit pathway use and outcomes rather than assuming a published algorithm is reliably implemented; emergency-care adherence has varied widely across guideline topics. [24]"
      ],
      "subsections": [],
      "table": {
        "caption": "",
        "columns": [],
        "rows": []
      }
    }
  ],
  "faq": [
    {
      "question": "Can a blood pressure value alone diagnose hypertensive emergency?",
      "answer": "No condition-specific diagnostic cutoff is supported by the supplied sources. The practical diagnosis requires evidence of acute target-organ injury; use current syndrome-specific guidance for the evaluation."
    },
    {
      "question": "Which intravenous antihypertensive and dose should be used?",
      "answer": "The supplied literature does not support a specific agent, dose, titration schedule, or blood-pressure target. Use an up-to-date institutional protocol and current specialty guidance tailored to the suspected organ injury."
    },
    {
      "question": "Should local emergency department hypertension protocols be followed automatically?",
      "answer": "No. ACEP states that guidelines should supplement care under emergency physician oversight and do not define the standard of care. [20] Confirm that the pathway is current, evidence-linked, and applicable to the patient’s clinical syndrome."
    }
  ],
  "references": [
    {
      "number": 1,
      "title": "Periorbital and orbital cellulitis in children: a survey of emergency physicians and analysis of clinical practice guidelines across the PERUKI network | Emergency Medicine Journal",
      "detail": "emj.bmj.com",
      "url": "https://emj.bmj.com/content/emermed/early/2022/03/09/emermed-2021-211713.full.pdf",
      "authors": "emj.bmj.com",
      "host": "emj.bmj.com"
    },
    {
      "number": 2,
      "title": "D-dimer thresholds in pulmonary embolism: avoiding one-size-fits-all - The Lancet Respiratory Medicine",
      "detail": "www.thelancet.com",
      "url": "https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(25)00303-0/abstract",
      "authors": "www.thelancet.com",
      "host": "www.thelancet.com"
    },
    {
      "number": 3,
      "title": "Protecting and monitoring the health of emergency responders",
      "detail": "www.thelancet.com",
      "url": "https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(15)00086-7/fulltext",
      "authors": "www.thelancet.com",
      "host": "www.thelancet.com"
    },
    {
      "number": 4,
      "title": "Recommended Guidelines for Monitoring, Reporting, and ...",
      "detail": "www.ahajournals.org",
      "url": "https://www.ahajournals.org/doi/10.1161/circulationaha.107.186227",
      "authors": "www.ahajournals.org",
      "host": "www.ahajournals.org"
    },
    {
      "number": 5,
      "title": "Medication Errors in Acute Cardiovascular and Stroke ...",
      "detail": "www.ahajournals.org",
      "url": "https://www.ahajournals.org/doi/10.1161/cir.0b013e3181d4b43e",
      "authors": "www.ahajournals.org",
      "host": "www.ahajournals.org"
    },
    {
      "number": 6,
      "title": "Direct Oral Anticoagulant Use: A Practical Guide to ...",
      "detail": "www.ahajournals.org",
      "url": "https://www.ahajournals.org/doi/10.1161/JAHA.120.017559",
      "authors": "www.ahajournals.org",
      "host": "www.ahajournals.org"
    },
    {
      "number": 7,
      "title": "Ultrasound Guidelines: Emergency, Point-of-Care and Clinical Ultrasound Guidelines in Medicine - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S0196064416309350",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com"
    },
    {
      "number": 8,
      "title": "Designing clinical guidelines that improve access and satisfaction in the emergency department - Pondicherry - 2023 - Journal of the American College of Emergency Physicians Open - Wiley Online Library",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/full/10.1002/emp2.12919",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com"
    },
    {
      "number": 9,
      "title": "ACEP emergency ultrasound guidelines–2001 - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S0196064401700303",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com"
    },
    {
      "number": 10,
      "title": "Rationale and design of the ICON-RELOADED study: International Collaborative of N-terminal pro–B-type Natriuretic Peptide Re-evaluation of Acute Diagnostic Cut-Offs in the Emergency Department - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S0002870317302004",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com"
    },
    {
      "number": 11,
      "title": "FDA Approval Summary: Nalmefene Nasal Spray for the ...",
      "detail": "ascpt.onlinelibrary.wiley.com",
      "url": "https://ascpt.onlinelibrary.wiley.com/doi/10.1002/cpt.3514",
      "authors": "ascpt.onlinelibrary.wiley.com",
      "host": "ascpt.onlinelibrary.wiley.com"
    },
    {
      "number": 12,
      "title": "Managing Drug–Drug Interactions in Older Adults",
      "detail": "accp1.onlinelibrary.wiley.com",
      "url": "https://accp1.onlinelibrary.wiley.com/doi/pdf/10.1002/jcph.2299",
      "authors": "accp1.onlinelibrary.wiley.com",
      "host": "accp1.onlinelibrary.wiley.com"
    },
    {
      "number": 13,
      "title": "Comprehensive guidance for antibiotic dosing in obese adults ...",
      "detail": "accpjournals.onlinelibrary.wiley.com",
      "url": "https://accpjournals.onlinelibrary.wiley.com/doi/10.1002/phar.2769",
      "authors": "accpjournals.onlinelibrary.wiley.com",
      "host": "accpjournals.onlinelibrary.wiley.com"
    },
    {
      "number": 14,
      "title": "Managing Drug–Drug Interactions in Older Adults - Zhou - 2023",
      "detail": "accp1.onlinelibrary.wiley.com",
      "url": "https://accp1.onlinelibrary.wiley.com/doi/full/10.1002/jcph.2299",
      "authors": "accp1.onlinelibrary.wiley.com",
      "host": "accp1.onlinelibrary.wiley.com"
    },
    {
      "number": 15,
      "title": "2024 CPDD Abstract Booklet - 2024 - Wiley Online Library",
      "detail": "accp1.onlinelibrary.wiley.com",
      "url": "https://accp1.onlinelibrary.wiley.com/doi/full/10.1002/cpdd.1459",
      "authors": "accp1.onlinelibrary.wiley.com",
      "host": "accp1.onlinelibrary.wiley.com"
    },
    {
      "number": 16,
      "title": "Regulatory Perspectives on Designing Pharmacokinetic ...",
      "detail": "accp1.onlinelibrary.wiley.com",
      "url": "https://accp1.onlinelibrary.wiley.com/doi/10.1177/0091270011415410",
      "authors": "accp1.onlinelibrary.wiley.com",
      "host": "accp1.onlinelibrary.wiley.com"
    },
    {
      "number": 17,
      "title": "Systematic review of emergency medicine clinical practice guidelines: Implications for research and policy - PMC",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5476239",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov"
    },
    {
      "number": 18,
      "title": "AN APPRAISAL OF EMERGENCY MEDICINE CLINICAL PRACTICE GUIDELINES: DO WE AGREE? - PMC",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6351191",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov"
    },
    {
      "number": 19,
      "title": "Designing clinical guidelines that improve access and satisfaction in the emergency department",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9990158",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov"
    },
    {
      "number": 20,
      "title": "Clinical Guidelines Affecting Emergency Medicine Practice | ACEP",
      "detail": "www.acep.org",
      "url": "https://www.acep.org/patient-care/policy-statements/clinical-guidelines-affecting-emergency-medicine-practice",
      "authors": "www.acep.org",
      "host": "www.acep.org"
    },
    {
      "number": 21,
      "title": "Emergency Care Guidelines - Annals of Emergency Medicine",
      "detail": "www.annemergmed.com",
      "url": "https://www.annemergmed.com/article/S0196-0644(97)70240-3/pdf",
      "authors": "www.annemergmed.com",
      "host": "www.annemergmed.com"
    },
    {
      "number": 22,
      "title": "Physician extenders - Emergency and acute medical care in over 16s: service delivery and organisation - NCBI Bookshelf",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/books/NBK564904",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov"
    },
    {
      "number": 23,
      "title": "Systematic review of emergency medicine clinical practice ...",
      "detail": "pubmed.ncbi.nlm.nih.gov",
      "url": "https://pubmed.ncbi.nlm.nih.gov/28628660",
      "authors": "pubmed.ncbi.nlm.nih.gov",
      "host": "pubmed.ncbi.nlm.nih.gov"
    },
    {
      "number": 24,
      "title": "Adherence to guidelines and protocols in the prehospital and emergency care setting: a systematic review - PMC",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC3599067",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov"
    }
  ],
  "editorialNote": "Prepared from cited clinical literature using Astra's research workflow. Verify recommendations against current guidance and patient-specific factors.",
  "citations": [
    {
      "number": 1,
      "title": "Periorbital and orbital cellulitis in children: a survey of emergency physicians and analysis of clinical practice guidelines across the PERUKI network | Emergency Medicine Journal",
      "detail": "emj.bmj.com",
      "url": "https://emj.bmj.com/content/emermed/early/2022/03/09/emermed-2021-211713.full.pdf",
      "authors": "emj.bmj.com",
      "host": "emj.bmj.com",
      "snippet": "## \n\n## Data availability statement\n\nData are available on reasonable request. Any further data required may be made available via request to the corresponding author.\n\n## Footnotes\n\nHandling editor Shammi L Ramlakhan\n\nTwitter @merieltc, @adamsonjon, @mdlyttle, @damian\\_roland\n\nContributors Conceptu",
      "score": 0.43136916
    },
    {
      "number": 2,
      "title": "D-dimer thresholds in pulmonary embolism: avoiding one-size-fits-all - The Lancet Respiratory Medicine",
      "detail": "www.thelancet.com",
      "url": "https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(25)00303-0/abstract",
      "authors": "www.thelancet.com",
      "host": "www.thelancet.com",
      "snippet": "# D-dimer thresholds in pulmonary embolism: avoiding one-size-fits-all. D-Dimer thresholds for diagnosis of pulmonary embolism based on a single question: is it the most likely diagnosis? A prospective, multicentre, open-label, single-arm interventional study00292-9/fulltext \"D-Dimer thresholds for ",
      "score": 0.33095807
    },
    {
      "number": 3,
      "title": "Protecting and monitoring the health of emergency responders",
      "detail": "www.thelancet.com",
      "url": "https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(15)00086-7/fulltext",
      "authors": "www.thelancet.com",
      "host": "www.thelancet.com",
      "snippet": "... Surveillance system, which is a framework that includes recommendations and strategies specific to protect emergency responders during all phases of a response.",
      "score": 0.19971387
    },
    {
      "number": 4,
      "title": "Recommended Guidelines for Monitoring, Reporting, and ...",
      "detail": "www.ahajournals.org",
      "url": "https://www.ahajournals.org/doi/10.1161/circulationaha.107.186227",
      "authors": "www.ahajournals.org",
      "host": "www.ahajournals.org",
      "snippet": "by MA Peberdy · 2007 · Cited by 236 — Free Access Recommended Guidelines for Monitoring, Reporting, and Conducting Research on Medical Emergency Team, Outreach, and Rapid Response Systems:",
      "score": 0.33921495
    },
    {
      "number": 5,
      "title": "Medication Errors in Acute Cardiovascular and Stroke ...",
      "detail": "www.ahajournals.org",
      "url": "https://www.ahajournals.org/doi/10.1161/cir.0b013e3181d4b43e",
      "authors": "www.ahajournals.org",
      "host": "www.ahajournals.org",
      "snippet": "by AD Michaels · 2010 · Cited by 130 — Therefore, careful attention to changes in renal and hepatic function and dose adjustment based on these parameters is essential.",
      "score": 0.32704523
    },
    {
      "number": 6,
      "title": "Direct Oral Anticoagulant Use: A Practical Guide to ...",
      "detail": "www.ahajournals.org",
      "url": "https://www.ahajournals.org/doi/10.1161/JAHA.120.017559",
      "authors": "www.ahajournals.org",
      "host": "www.ahajournals.org",
      "snippet": "by A Chen · 2020 · Cited by 693 — Dabigatran, apixaban, and edoxaban are viable options in patients with moderate hepatic impairment and do not require dose adjustments.38",
      "score": 0.16466448
    },
    {
      "number": 7,
      "title": "Ultrasound Guidelines: Emergency, Point-of-Care and Clinical Ultrasound Guidelines in Medicine - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S0196064416309350",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "# Policy statement Ultrasound Guidelines: Emergency, Point-of-Care and Clinical Ultrasound Guidelines in Medicine. Ultrasound (US) has become an integral modality in emergency care in the United States during the last two decades. Emergency Ultrasound (EUS) is the medical use of US technology for th",
      "score": 0.6688159
    },
    {
      "number": 8,
      "title": "Designing clinical guidelines that improve access and satisfaction in the emergency department - Pondicherry - 2023 - Journal of the American College of Emergency Physicians Open - Wiley Online Library",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/full/10.1002/emp2.12919",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "As healthcare use increases in the United States, developing and implementing clinical guidelines has become increasingly supported by federal investment and adopted across multiple practice settings.1, 2 Clinical guidelines are commonly used throughout the hospital and range broadly, including ever",
      "score": 0.666736
    },
    {
      "number": 9,
      "title": "ACEP emergency ultrasound guidelines–2001 - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S0196064401700303",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Title: ACEP emergency ultrasound guidelines–2001 - ScienceDirect\nThe clinical application of ultrasonography by emergency physicians has greatly expanded over the past decade.1, 2, 3, 4, 5 Emergency physicians have adopted ultrasound to advance the timely and accurate evaluation and treatment of the",
      "score": 0.44463772
    },
    {
      "number": 10,
      "title": "Rationale and design of the ICON-RELOADED study: International Collaborative of N-terminal pro–B-type Natriuretic Peptide Re-evaluation of Acute Diagnostic Cut-Offs in the Emergency Department - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S0002870317302004",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Title: Rationale and design of the ICON-RELOADED study: International Collaborative of N-terminal pro–B-type Natriuretic Peptide Re-evaluation of Acute Diagnostic Cut-Offs in the Emergency Department - ScienceDirect\n# Trial Design Rationale and design of the ICON-RELOADED study: International Collab",
      "score": 0.52042377
    },
    {
      "number": 11,
      "title": "FDA Approval Summary: Nalmefene Nasal Spray for the ...",
      "detail": "ascpt.onlinelibrary.wiley.com",
      "url": "https://ascpt.onlinelibrary.wiley.com/doi/10.1002/cpt.3514",
      "authors": "ascpt.onlinelibrary.wiley.com",
      "host": "ascpt.onlinelibrary.wiley.com",
      "snippet": "no dosage adjustment is needed in elderly patients, or in patients with renal or hepatic impairment for nalmefene nasal spray for single",
      "score": 0.37731177
    },
    {
      "number": 12,
      "title": "Managing Drug–Drug Interactions in Older Adults",
      "detail": "accp1.onlinelibrary.wiley.com",
      "url": "https://accp1.onlinelibrary.wiley.com/doi/pdf/10.1002/jcph.2299",
      "authors": "accp1.onlinelibrary.wiley.com",
      "host": "accp1.onlinelibrary.wiley.com",
      "snippet": "by Z Zhou · 2023 · Cited by 23 — Prescribing information for these 3 drugs indicate that dosage adjustments corresponding to different levels of renal impairment are required.",
      "score": 0.313683
    },
    {
      "number": 13,
      "title": "Comprehensive guidance for antibiotic dosing in obese adults ...",
      "detail": "accpjournals.onlinelibrary.wiley.com",
      "url": "https://accpjournals.onlinelibrary.wiley.com/doi/10.1002/phar.2769",
      "authors": "accpjournals.onlinelibrary.wiley.com",
      "host": "accpjournals.onlinelibrary.wiley.com",
      "snippet": "Telavancin 750 mg every 24 h; Does not include dose adjustments for renal and/or hepatic impairment. pathogen, and site of infection. h may be",
      "score": 0.26072624
    },
    {
      "number": 14,
      "title": "Managing Drug–Drug Interactions in Older Adults - Zhou - 2023",
      "detail": "accp1.onlinelibrary.wiley.com",
      "url": "https://accp1.onlinelibrary.wiley.com/doi/full/10.1002/jcph.2299",
      "authors": "accp1.onlinelibrary.wiley.com",
      "host": "accp1.onlinelibrary.wiley.com",
      "snippet": "by Z Zhou · 2023 · Cited by 23 — no dosage adjustment is essential. Emergency Use Authorization from the US Food and Drug Administration, although the instruction provided",
      "score": 0.2498181
    },
    {
      "number": 15,
      "title": "2024 CPDD Abstract Booklet - 2024 - Wiley Online Library",
      "detail": "accp1.onlinelibrary.wiley.com",
      "url": "https://accp1.onlinelibrary.wiley.com/doi/full/10.1002/cpdd.1459",
      "authors": "accp1.onlinelibrary.wiley.com",
      "host": "accp1.onlinelibrary.wiley.com",
      "snippet": "Assess the Effect of Hepatic Impairment on Avapritinib Pharmacokinetics to Guide Dose Adjustment A.",
      "score": 0.123059906
    },
    {
      "number": 16,
      "title": "Regulatory Perspectives on Designing Pharmacokinetic ...",
      "detail": "accp1.onlinelibrary.wiley.com",
      "url": "https://accp1.onlinelibrary.wiley.com/doi/10.1177/0091270011415410",
      "authors": "accp1.onlinelibrary.wiley.com",
      "host": "accp1.onlinelibrary.wiley.com",
      "snippet": "The 2010 FDA draft guidance on renal impairment provides several updated recommendations that include criteria or principles for evaluating the",
      "score": 0.121487826
    },
    {
      "number": 17,
      "title": "Systematic review of emergency medicine clinical practice guidelines: Implications for research and policy - PMC",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5476239",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "We included all American College of Emergency Physician Clinical Policies listed as both “current” and “past” from the ACEP Clinical & Practice Management website, . ACEP Clinical Policies are the only regularly published, medical specialty society sponsored clinical practice guidelines specific to ",
      "score": 0.7009158
    },
    {
      "number": 18,
      "title": "AN APPRAISAL OF EMERGENCY MEDICINE CLINICAL PRACTICE GUIDELINES: DO WE AGREE? - PMC",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6351191",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "clinical policies are authored by ACEP and follow the ACEP clinical policy development process, which includes expert review from medical specialists and societies relevant to the clinical topic. ACEP clinical policies are specific to emergency care in the United States, are regularly published and ",
      "score": 0.6824261
    },
    {
      "number": 19,
      "title": "Designing clinical guidelines that improve access and satisfaction in the emergency department",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9990158",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "Recognizing the importance of clinician trust in clinical guidelines, our team collaborated with emergency leadership to develop a rigorous change‐control process whereby emergency leadership reviewed and cross‐referenced each newly converted guideline before publication. Specialty‐specific clinical",
      "score": 0.66777676
    },
    {
      "number": 20,
      "title": "Clinical Guidelines Affecting Emergency Medicine Practice | ACEP",
      "detail": "www.acep.org",
      "url": "https://www.acep.org/patient-care/policy-statements/clinical-guidelines-affecting-emergency-medicine-practice",
      "authors": "www.acep.org",
      "host": "www.acep.org",
      "snippet": "* American College of Emergency Physicians. / * Clinical Guidelines Affecting Emergency Medicine Practice. # Clinical Guidelines Affecting Emergency Medicine Practice. **Revised February 2020, January 2014 with current title**. **Originally approved July 2001 titled \"Voluntary Guidelines for Emergen",
      "score": 0.6612456
    },
    {
      "number": 21,
      "title": "Emergency Care Guidelines - Annals of Emergency Medicine",
      "detail": "www.annemergmed.com",
      "url": "https://www.annemergmed.com/article/S0196-0644(97)70240-3/pdf",
      "authors": "www.annemergmed.com",
      "host": "www.annemergmed.com",
      "snippet": "# Emergency Care Guidelines. [American College of Emergency Physicians: Emergency care guidelines. * Emergency care guidelines80503-9/fulltext \"Emergency care guidelines\"). * Emergency care guidelines81090-X/fulltext \"Emergency care guidelines\"). * Emergency care guidelines81085-6/fulltext \"Emergenc",
      "score": 0.6353361
    },
    {
      "number": 22,
      "title": "Physician extenders - Emergency and acute medical care in over 16s: service delivery and organisation - NCBI Bookshelf",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/books/NBK564904",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov",
      "snippet": "Mortality, quality of life, length of stay, avoidable adverse events and patient and/or carer satisfaction were considered by the guideline committee to be critical outcomes.\n\nReadmission, discharges, missed or delayed treatments, and staff satisfaction were considered important outcomes.\n\nThe revie",
      "score": 0.58123237
    },
    {
      "number": 23,
      "title": "Systematic review of emergency medicine clinical practice ...",
      "detail": "pubmed.ncbi.nlm.nih.gov",
      "url": "https://pubmed.ncbi.nlm.nih.gov/28628660",
      "authors": "pubmed.ncbi.nlm.nih.gov",
      "host": "pubmed.ncbi.nlm.nih.gov",
      "snippet": "by AK Venkatesh · 2017 · Cited by 45 — Emergency medicine clinical practice guidelines are largely based on lower classes of evidence and a majority of recommendations are expert",
      "score": 0.51603514
    },
    {
      "number": 24,
      "title": "Adherence to guidelines and protocols in the prehospital and emergency care setting: a systematic review - PMC",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC3599067",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "| Emergency Department  --- |  |  |  |  |  |  |  |\n| Atreja  --- | Retrospective, descriptive  --- | Chart review  --- | Monocenter: 1 ED  --- | Emergency physicians  --- | 94 patients with an elevated international normalized ratio (INR)  --- | American College of Chest Physicians recommendations f",
      "score": 0.50241756
    }
  ],
  "publishedAt": "2026-08-20T23:20:27.359657Z",
  "updatedAt": "2026-08-20T23:20:27.359657Z",
  "readingMinutes": 3,
  "slug": "hypertensive-emergency"
}