Critical Care 1 – Subarachnoid Hemorrhage

This is the first case in a series looking at critical care medicine. A previously healthy 46-year old woman is transferred from a surrounding hospital with CT-confirmed diagnosis of SAH with hydrocephalus. The patient is transferred direct to Neurosurgery and booked for OR but experiences progressive decreases in her GCS while awaiting surgery.

Learner-Consultant Communication

In this case, learners will be expected to recognize that this 58-year-old female patient with metastatic non-small-cell lung cancer has tamponade physiology secondary to a malignant pericardial effusion. The patient will stabilize somewhat with a gentle fluid bolus but the learners will be expected to urgently consult cardiology or cardiac/thoracic surgery (depending on the centre) for a pericardiocentesis and/or pericardial window.