SAQ 165 – Neurology – subarachnoid haemorrhage

Review Completed

Marked out of 12.00

A 30-year-old man presents to a regional emergency department with headache. His CT head is shown below.

CT head for Geelong SAQ 018 question 8 — CT head

State two (2) abnormalities shown in the CT scan.

(Marked out of 2.0)

/ 2

List four (4) examination features that would indicate severe disease.

(Marked out of 4.0)

/ 4

On review, his headache pain score is 8/10 and he has received only 10 mg oxycodone. He has two large-bore IVs, full non-invasive monitoring, and is in a resuscitation cubicle. His observations are BP 220/100 mmHg, HR 90/min, temperature 36.8 C, oxygen saturation 99% on room air, and GCS 15. List three (3) key management steps over the next 30 minutes and state one point of detail for each.

(Marked out of 6.0)

Management step	Detail
1.
2.
3.

/ 6

Total Score: 0 / 12

Percentage: 0%

Management step	Detail
Analgesia	Titrate IV opioid analgesia to pain and sedation level.
Blood pressure control	Use titrated IV antihypertensive therapy with a systolic target agreed with neurosurgery, commonly 140-160 mmHg.
Prevent secondary injury and arrange definitive care	Head elevation, avoid hypoxia/hyperthermia/abnormal glucose, consider hyperosmolar or anticonvulsant therapy, and arrange urgent neurosurgical retrieval.

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