Intracranial hemorrhage deterioration
Educational use only. Not clinically reviewed72-year-old man for Emergency stabilization, reversal intent, pressure control, and neurosurgical transfer. About 9 simulated minutes.
What you will practise
- Recognize neurologic deterioration, reassess airway, breathing, circulation, and glucose, and activate the hemorrhage pathway.
- Review the authored hemorrhage, intraventricular extension, hydrocephalus, warfarin exposure, and INR.
- Stop warfarin and record urgent 4-factor PCC plus IV vitamin K reversal intent.
- Record smooth, sustained systolic pressure control toward 140 mmHg while avoiding less than 130 mmHg.
- Activate neurocritical and neurosurgical transfer for hydrocephalus evaluation and hand off serial findings.
Review and sources
Not clinically reviewed. No clinician has signed this scenario.
- Greenberg SM, et al. 2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage. Stroke. 2022;53:e282-e361. doi:10.1161/STR.0000000000000407.
Open Sim Lab is an educational simulator, not for clinical use. It is not a clinical decision-support tool, not a dosing calculator, and is not validated for any decision affecting a real patient.