Round 11 (Headache)

Summary: <br> CAUTION: THESE NOTES CONTAIN SPOILERS!!!<br> <br> <br> <br> Case Introduction<br> <br> <br> <br> 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… <br> <br> <br> <br> Initial Vitals<br> <br> <br> <br> * Temp 98.9* HR 99* RR 18* BP 180/110* O2 94%<br> <br> <br> <br> Critical Actions<br> <br> <br> <br> * Verbalize a Full Neurologic Examination* Obtain CT Scan Without Contrast* Consult Neurosurgery for Subarachnoid Hemorrhage* Reverse Warfarin Coagulopathy* Administer Antihypertensives<br> <br> <br> <br> Final Diagnosis<br> <br> <br> <br> Acute Subarachnoid Hemorrhage on Anticoagulation<br> <br> <br> <br> Tips and Tricks<br> <br> <br> <br> Always ask the patient if they have allergies prior to administering ANYTHING.<br> <br> <br> <br> Additional Reading<br> <br> <br> <br> * Basics of Subarachnoid Hemorrhage <a href="http://www.emclerkship.com/subarachnoid-hemorrhage-critical-diagnosis/">(EM Clerkship)</a>* How to Reverse Warfarin <a href="https://www.ahajournals.org/doi/full/10.1161/circulationaha.111.081489">(AHA)</a><br>