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Any patient > 18 years old in the health care system [A] Obtain blood presure (BP) to screen for hypertension [B] Is SBP > 210 or DBP > 90? Treat or refer immediately Is SBP > 140 or DBP > 90? Manage Hypertension Continue on page H2 Follow-up as indicated
Patient with low back pain/sciatica age > 17 [A]
History and physical examination [B]
Does the patient have any RED FLAGS: [C] Major trauma Age > 50 Persistent fever History of cancer Metabolic disorder Major muscle weakness Bladder or bowel dysfunction Saddle anesthesia Decreased sphincter tone Unrelenting night pain?
Initiate immediate and appropriate action [D]
Workup abnormal?
Refer/manage as appropriate
Does patient have another medical condition presenting as back pain? [E]
Refer/manage as appropriate
Back pain > 6 weeks?
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