Episode 4 – Subarachnoid Hemorrhage Guidelines - a podcast by Scott D. Weingart, MD FCCM

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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