SAH Emergency Management:
1. ๐ซ Avoid Hypotension:
- Maintain MAP>80, CPP 60 (ICP<20)
- IV Fluids, Pressors if needed
2. ๐ฉธ Hypertension Management:
- SBP <160 reasonable; <140 may improve outcomes
- Pain control, sedation before antihypertensives
3. ๐ Stop/Reverse Anticoagulation:
- Coumadin โ Kcentra/FFP + Vitamin K
- Aspirin โ DDAVP
- Plavix โ Platelets
- Dabigatran โ Idarucizumab
4. ๐ Nimodipine:
- Improves outcomes, 60mg q4hr PO/NGT, monitor BP
5. ๐งช Magnesium Sulfate:
- Controversial, 2-2.5 mmol/L
6. ๐ Seizure Prophylaxis:
- Short course, choose Phenytoin/Levetiracetam/etc.
7. ๐ Glucocorticoid Therapy:
- Controversial, no clear benefit/harm
8. ๐ฌ Glycemic Control:
- Consider in prolonged ED stays
9. ๐๏ธ Elevate Bed Head
10. ๐ง Aneurysm Treatment:
- Surgical clipping, coiling, short-term antifibrinolytics
๐ก๏ธ Intubation:
- Neuroprotective approach, Lidocaine, Fentanyl, Sedation (Etomidate/Propofol)
1. ๐ซ Avoid Hypotension:
- Maintain MAP>80, CPP 60 (ICP<20)
- IV Fluids, Pressors if needed
2. ๐ฉธ Hypertension Management:
- SBP <160 reasonable; <140 may improve outcomes
- Pain control, sedation before antihypertensives
3. ๐ Stop/Reverse Anticoagulation:
- Coumadin โ Kcentra/FFP + Vitamin K
- Aspirin โ DDAVP
- Plavix โ Platelets
- Dabigatran โ Idarucizumab
4. ๐ Nimodipine:
- Improves outcomes, 60mg q4hr PO/NGT, monitor BP
5. ๐งช Magnesium Sulfate:
- Controversial, 2-2.5 mmol/L
6. ๐ Seizure Prophylaxis:
- Short course, choose Phenytoin/Levetiracetam/etc.
7. ๐ Glucocorticoid Therapy:
- Controversial, no clear benefit/harm
8. ๐ฌ Glycemic Control:
- Consider in prolonged ED stays
9. ๐๏ธ Elevate Bed Head
10. ๐ง Aneurysm Treatment:
- Surgical clipping, coiling, short-term antifibrinolytics
๐ก๏ธ Intubation:
- Neuroprotective approach, Lidocaine, Fentanyl, Sedation (Etomidate/Propofol)
๐4โค2
Syncope - transient loss of consciousness caused by transient global cerebral hypoperfusion with rapid onset, short duration and spontaneous complete recovery; MCC of syncope (mnemonic) โ> HEAD HEART VESSELS
๐๐ข๐๐๐'๐ฆ ๐๐ฅ๐๐๐ง๐จ๐ฅ๐ -Dinner Fork Deformity
๐Fx of distal end of radius at its cortico cancellous junction,described by Abraham Colles in 1814
๐It occurs due to ๐ผ๐๐๐๐๐ฟ๐ฒ๐๐ฐ๐ต๐ฒ๐ฑ ๐ต๐ฎ๐ป๐ฑ having hx of fall, & has swelling,pain,tenderness at site of trauma
๐Fx of distal end of radius at its cortico cancellous junction,described by Abraham Colles in 1814
๐It occurs due to ๐ผ๐๐๐๐๐ฟ๐ฒ๐๐ฐ๐ต๐ฒ๐ฑ ๐ต๐ฎ๐ป๐ฑ having hx of fall, & has swelling,pain,tenderness at site of trauma
๐3