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Coiling of subarachnoid haemorrhage (SAH)

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Considerations as for anaesthesia in-a-remote-or-hazardous-environment

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May 17, 2012
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At risk of cerebral aneurism perforation. Consider your contingency plan if this occurs.

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May 17, 2012
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Distal coil migration is an uncommon risk. #incidence

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May 17, 2012
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If aneurysm perforation occurs, commence cerebral protection manouvers, reverse anticoagulation, continue coiling, have neurosurgeon insert EVD.

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May 23, 2012
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May need to reverse the heparin emergently if aneurism ruptures. Have protamine available.

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Jun 16, 2011
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Place anaesthetic machine and tubing in a position that won't be caught in C-arm of image intensifier.

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Jun 16, 2011
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Minimise hypertensive response to laryngoscopy to reduce risk of aneurism rupture with adequately dosed and timed opioid.

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Apr 07, 2012
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Wake patient at end of case for neurological assessment. Wake in angiography suite then transfer to recovery, or if time pressure, transfer to recovery and wake there.

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