Page 314 - 2021 IDMT Digital

SUBARACHNOID HEMORRHAGE
Introduction:
• 6SRQWDQHRXV KHPRUUKDJH IUHTXHQWO\ UHVXOWV IURP WKH UXSWXUH RI DQ DUWHULDO VDFFXODU
³EHUU\´ DQHXU\VP RU IURP DQ DUWHULRYHQRXV PDOIRUPDWLRQ
• %HWZHHQ RI VWURNHV DUH GXH WR VXEDUDFKQRLG KHPRUUKDJH
• 7UDXPD LV WKH PRVW FRPPRQ FDXVH

Subjective:
• 6LJQV DQG 6\PSWRPV
o 3DWLHQWV ZLWK DQHXU\VPV PD\ H[SHULHQFH KHDGDFKHV QDXVHD DQG QHFN VWLIIQHVV
D IHZ KRXUV RU GD\V EHIRUH PDVVLYH VXEDUDFKQRLG KHPRUUKDJH RFFXUV
o 6XGGHQ "thunderclap" KHDGDFKH RI D VHYHULW\ QHYHU H[SHULHQFHG EHIRUH IROORZHd
by nausea DQG YRPLWLQJ
o /RVV RU LPSDLUPHQW RI FRQVFLRXVQHVV
o ,UULWDELOLW\ FRQIXVLRQ FRPD DQG GHDWK DV KHPRUUKDJH SURJUHVVHV
Objective:
• 3K\VLFDO ([DP
o 5HTXLUHV FRPSOHWH QHXURORJLFDO H[DP
o $OWHUHG PHQWDO VWDWXV ZLOO EH GLVSOD\HG DV V\PSWRPV ZRUVHQ
o 1XFKDO ULJLGLW\ VLJQV RI PHQLQJHDO LUULWDWLRQ
o )RFDO QHXURORJLF GHILFLWV SRVVLEOH
• 7RROV
o &7 ZLOO VKRZ KHPRUUKDJH KDV RFFXUUHG
o /XPEDU SXQFWXUH PD\ GHPRQVWUDWH UHG EORRG FHOOV LQ WKH FHUHEURVSLQDO IOXLG
Assessment:
• 'LIIHUHQWLDO
o 0HQLQJLWLV FRQVWLWXWLRQDO V\PSWRPV
o 0LJUDLQH KHDGDFKH JHQHUDOO\ ODFNLQJ DOWHUHG PHQWDO VWDWXV
o $FXWH K\SHUWHQVLYH FULVLV YLWDO VLJQV
Plan:
• (9$& RU WUDQVIHU DOO SDWLHQWV VKRXOG EH HYDFXDWHG DQG VHHQ E\ D QHXURVXUJHRQ
• &RQVFLRXV SDWLHQWV VKRXOG EH DGYLVHG DJDLQVW DQ\ VWUDLQLQJ RU H[HUWLRQ
• 7KH PDMRU DLP RI WUHDWPHQW LV WR SUHYHQW IXUWKHU KHPRUUKDJH

Patient Education:
• 3URFHHG WR WKH (5 LI \RX KDYH WKH ³ZRUVW KHDGDFKH RI \RXU OLIH"
• )ROORZ XS $FWLRQV
o &RQWLQXH WR IROORZ XS ZLWK VSHFLDOW\ FDUH QHXURORJ\
Preceptor Directive:
• Red Directive: Immediate Evacuation; Contact Preceptor ASAP

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