Case Presentation: A 54-year-old tracheostomy and gastric tube dependent, non-verbal male with chronic spastic quadriplegia, autonomic dysautonomia, and recent ICU admissions for MDR pneumonia presented to the emergency department from his skilled nursing facility with acute hypertension. His home medications were notable for hydralazine, isosorbide mononitrate, clonidine, midodrine, and an intrathecal baclofen pump. He was [...]