Round 11 (Headache)

CAUTION: THESE NOTES CONTAIN SPOILERS!!!



Case Introduction



You are having a busy day in the department when you are paged overhead to the resuscitation bay for an ill appearing patient with a headache…



Initial Vitals



* Temp 98.9* HR 99* RR 18* BP 180/110* O2 94%



Critical Actions



* Verbalize a Full Neurologic Examination* Obtain CT Scan Without Contrast* Consult Neurosurgery for Subarachnoid Hemorrhage* Reverse Warfarin Coagulopathy* Administer Antihypertensives



Final Diagnosis



Acute Subarachnoid Hemorrhage on Anticoagulation



Tips and Tricks



Always ask the patient if they have allergies prior to administering ANYTHING.



Additional Reading



* Basics of Subarachnoid Hemorrhage (EM Clerkship)* How to Reverse Warfarin (AHA)