Preeclampsia Presentation in the ED

   

  Preeclampsia is a life threatening condition that presents in pregnancy over 20 weeks and up to 6 weeks postpartum. For a refresher on what preeclampsia is check out this Youtube video (a well spent 6 minutes!).

 

https://www.youtube.com/watch?v=RB5s85xDshA

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Assessment points for ED nurses

• The threshold for hypertension is much lower in obstetrical populations (and those up to 6 weeks postpartum) SBP greater than 140 mmHg and DBP greater than 90 mmHg are cause for concern

• Oxygen saturation below 97% (with or without dyspnea) are cause for concerns saturations below 93% are associated with infant and maternal mortality

• Commonly discussed clinical symptoms such as headache, edema or blurred vision are not always present and may be intermittent

• Postpartum mothers diagnosed and delivered for preeclampsia who present to the ED with symptoms and/or abnormal VS are considered extremely high risk in the obstetrical setting, especially if they are on continued antihypertensive medication

• When triaging, consider the lower threshold for VS stability and adjust your CTAS level accordingly (ie CTAS 2 or greater)

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Remember: Be aware of the assessment points as above, if you suspect preeclampsia advocate for urgent assessment by the ED Physician.