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Episode 4 – Subarachnoid Hemorrhage Guidelines


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The Recs:
 

* Use Hunt & Hess or WFN Scores
* Risk of early rebleeding is high – be quick and decisive in getting the aneurysm secured
* Still recommending LP if negative CT
* Get CTA if CT or LP is positive
* MRI may be useful if negative CT, but if negative you still need a LP
* Keep SBP < 160 until clip/coil
* If delay until clip/coil, use aminocaproic acid or TXA
* Give nimodipine to prevent delayed cerebral ischemia
* Need CSF drainage if acute, symptomatic hydrocephalus
* Consider anti-convulsants in acute SAH management
* Use isotonic fluids, keep fluid balance positive
* Keep patient Normothermic
* Control Hyperglycemia

from:
Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage
doi: 10.1161/?STR.0b013e3182587839
What is EMCrit drinking?
An insanely good aged sour ale: Rodenbach 2009 Vintage

 
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EMCrit FOAM FeedBy Scott D. Weingart, MD FCCM

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