Subarachnoid Hemorrhage (SAH)

First Things First (assess & treat for the following)

• Check level of consciousness; determine airway patency and risk of aspiration.
• Secure airway (i.e., intubate) if GCS is < 8; also consider early intubation if GCS is initially better but worsening.
• Obtain a non-contrast CT scan of the head as soon as the patient is stable.
• Monitor BP closely. Once presence of SAH is established, treat hypertension aggressively to limit further bleeding, until controlled by surgical clip or other intervention.
• Maintain normocapnia and adequate oxygenation in intubated and mechanically ventilated patient.