Ep 195 Management of Subarachnoid Hemorrhage
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May 28, 2024 Dr. Katie Lin and Dr. Jeff Perry discuss essential priorities in managing subarachnoid hemorrhage, including CT plus CTA, nimodipine use, and preventing rebleeding. They highlight prognostic tools for patient counseling. The podcast explores optimizing care, vasospasm, seizure prophylaxis, neuroprognostication, acute management strategies, and emerging trends in emergency medicine.
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Clinical Prediction Challenges
- Clinically predicting whether a stroke is ischemic or hemorrhagic is unreliable.
- Ischemic strokes can present with headaches, although it's not typical.
Managing Hypotension and Hypoxia
- Avoid hypotension and hypoxia in subarachnoid hemorrhage (SAH) patients by addressing vital signs early.
- Initiate oxygen, manage airways, and give fluid boluses or vasopressors as needed.
Raised ICP Management
- Manage raised ICP in SAH patients in tiered stages, starting with raising the head of the bed and pain management.
- Consider hyperosmolar therapies, intubation, and neurosurgical interventions as needed.