mmHg diastolic. The median time to receive the first AHM was 45.5 minutes (0-232 minutes). AHM treatment was within 30 minutes in 28.1%, within 60 minutes in 59.2% and >60 minutes in 40.8%. The median duration of SRBP was 77 minutes (18-450 minutes). The median time for the provider to order AHM was 42.9 minutes (0-194 minutes), for pharmacy approval was 7 minutes (0-23 minutes), and for administration by the nurse was 3 min (0-20 minutes). There was no correlation between time to treatment and severity of SRBP, GA, race, or time of day. The AHM used were labetalol (46.1%), hydralazine (35.5%) and nifedipine IR (18.4%). The median time to up-titration was 42 minutes (15-100 minutes). CONCLUSION: Despite national guidelines, many patients did not receive recommended AHM therapy and had SRBP for extended periods of time. Hospitals should evaluate their AHM timing, as frequency and etiology of delays are not always recognized. Protocols to facilitate timely treatment of patients with SRBPs are warranted.

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