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)