I agree with systemet, I think we all have a different picture of what this pt looks like. I would not be very aggressive with treating the BP, especially in the field. There is no urgent need to fix it, especially since we don't know what the pt normally runs. This could be her normal for the last few months and dropping it precipitously will cause problems. She certainly needs evaluation for end organ damage in the ER, but I think from the field perspective your best bet is to monitor and transport. Treating her headache wouldn't be a bad idea. I would avoid toradol because she has a motrin allergy and because we haven't ruled out a bleed yet. Otherwise, it would be appropriate. Morphine would be fine. I would give this woman an extra dose of her lisinopril and work her up. If we get her feeling better and there is no end organ issues, I would call the PMD and see what he wants to adjust. If there is end organ damage, obviously we will need to up our game a bit.