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Coma Scales. The primary goal of the neurologic examination in an unresponsive patient is to localize the lesion and thereby narrow the differential diagnosis. The examination should proceed in a stepwise fashion and be familiar to the neurologist because of constant repetition.
Severe uncontrolled hypertensionâ . Initiate treatment and follow-up within one to seven days of presentation. Initiate a maintenance dose of an oral medication before discharge in patients with SBP of 200 mm Hg or greater, or DBP of 120 mm Hg or greater; this is optional for patients with lower blood pressure. Safely discharge the patient, emphasizing the importance of close follow-up. note: Severe asymptomatic hypertension is defined as SBP of 180 mm Hg or greater, or DBP of 110 mm Hg or greater in a patient without signs or symptoms of end-organ damage. DBP = diastolic blood pressure; SBP = systolic blood pressure.