Protocol 4-167 - Chronic Hypertension Management

CMH EMS & MIH Protocols

Condition GREEN: All Clear Zone... This is the safety zone.
Indications:
  • None of the YELLOW or RED indications are present.
What you can do:
  • Track your daily sodium intake.
  • Take your medications as ordered.
  • Follow healthy eating habits: low salt and low sodium foods.
  • Balance activity and rest periods.
  • Keep all medical appointments.
What your CHW might do:
  • Review health history and PCP care plan prior to visit.
  • Answer any questions and address any concerns you have.
  • Review any discharge instructions from any hospital, emergency room, and/or doctor visits.
  • Review goals from previous visit:__________
  • Assess adherence to care plan, including diet, exercise, medications, and keeping appointments.
  • Review sodium intake log and weight log.
  • Perform a 12-lead ECG.
  • Review disease process and prevention measures with you including how and when to correctly take your medications.
  • Education on hypertension is to be expected for every encounter specific to your diagnosis(es).
  • Education on healthy eating and living habits is to be expected for every encounter.
  • Specific education on ACE inhibitors, beta blockers, and diuretics as it relates to hypertention and fatigue will be provided.
  • Complete a History and Physical Exam.
  • A complete Medications Reconciliation is to be expected at every encounter.
  • Complete a Safety Assessment.
  • Complete a Social Assessment.
  • Facilitate a Telehealth visit, if scheduled.
  • Follow any verbal orders as obtained via telehealth, phone call, or electronic messaging.
  • Schedule follow-up appointment(s) as needed that might include, but not limited to: Primary Care Provider, Addiction Recovery, Behavioral Health, Dental Care, Dietician, Home Health, Home Medical Equipment, Hospice, Pharmacy Services, Therapy Services, Public Health, Wound Care
  • Establish goals for next visit:__________




What your CP might do:
  • Ensure completion of applicable CHW items above.
  • Perform venous blood draw for the following test panel:
    • BNP
    • BUN
    • CBC
    • CMP
    • Creatinine
    • Lipids
    • Troponin
  • Perform heart Ultrasound.
Condition YELLOW: Warning Zone... This is the watch zone.
Indications:
  • None of the RED indications are present.
  • Blood pressure greater than 140/90 but less than 220/115 (either number)
  • An uneasy feeling or you know something is not right,
  • Fatigue or no energy,
  • Other indication set by your doctor:____________________
What you can do:
  • You may need an adjustment to your medications.
  • Improve your eating habits.
  • Increase your activity level.
  • Call your CHW or CP:____________________
  • Call your PCP:____________________
    • If outside business hours, 24-hour triage nurse screening is available by calling your PCP's number.
What your CHW might do:
  • Ensure completion of applicable items in the GREEN zone above.
What your CP might do:
  • Ensure completion of applicable CHW items above.
Condition RED: Medical Alert Zone... This is the danger zone.
Indications:
  • Chest pain,
  • Severe difficulty breathing,
  • Unrelieved shortness of breath while sitting still,
  • Altered mental status, confusion, or inability to think clearly,
  • Dizziness,
  • Blood pressure greater than 220/115 (either number)
  • SpO2 less than 88%,
  • Other indication set by your doctor:____________________
What you can do:
  • You need immediate evaluation by a medical professional.
  • Call your CHW or CP:____________________
  • Call your PCP:____________________
    • If outside business hours, 24-hour triage nurse screening is available by calling your PCP's number.
  • Call 9-1-1
What your CHW might do: What your CP might do:
  • Ensure completion of applicable CHW items above.
  • Assist you in the administration of your own prescribed medications.

NEMSIS Protocol: 9914175 - General-Community Paramedicine / Mobile Integrated Healthcare

Citations:

Change Log:

DateLink to
previous
version		Description of change
03/16/23Created this section.
05/11/23pdfFirst draft of MIH protocol.
05/26/23pdfAdded review of discharge instructions.

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