Management of hypertensive crises in emergency units: a critical review of care protocols

Abstract

Hypertensive crisis episodes are severe clinical conditions characterized by a sudden and intense rise in blood pressure, posing a risk of damage to target organs such as the heart, brain, and kidneys. Objective: To analyze the care protocols used in the management of hypertensive crises in emergency units, identifying strategies that promote safe and effective care. Methodology: An integrative literature review was conducted, gathering evidence from quantitative, qualitative, and systematic review studies. The search was carried out in PubMed, Scopus, Web of Science, SciELO, and LILACS, using the descriptors “Hypertensive Crises,” “Emergency Units,” “Care Protocols,” and “Patient Safety.” Studies published between 2018 and 2025 in Portuguese, English, or Spanish were included. Results: The use of structured protocols reduces response time, increases the predictability of care, and supports timely interventions. It also improves resource allocation and decreases complications such as stroke and renal failure. Discussion: The effectiveness of management depends on continuous team training and consistent application of evidence-based protocols. Conclusion: Structured protocols in emergency units are essential to optimize care, ensure patient safety, and improve clinical and organizational outcomes