Overview
Introduction
An aneurysmal subarachnoid haemorrhage (aSAH) patient may look deceptively well after the first headache, yet remain at risk for rebleeding, hydrocephalus, cardiac injury, and d...
An aneurysmal subarachnoid haemorrhage (aSAH) patient may look deceptively well after the first headache, yet remain at risk for rebleeding, hydrocephalus, cardiac injury, and delayed cerebral ischaemia (DCI). The NP's priorities therefore run in parallel: recognize the sentinel presentation, stabilize without compromising cerebral perfusion, arrange urgent aneurysm treatment, and transfer to a centre with neurocritical and aneurysm-treatment expertise. The practical goal is not simply to lower a blood-pressure reading or treat an abnormal scan. It is to prevent another arterial rupture while preserving flow to vulnerable brain, then identify secondary injury before it becomes an infarct. Canada has no standalone national SAH guideline; Canadian care combines current AHA/ASA aSAH guidance with the receiving neurosciences centre's protocol. NP prescribing, ordering, consultation, and referral must remain within the applicable provincial or territorial standards, formulary, competence, and local policy.