Treatment

-Stat neurosurgery consult.

-Head of bed at 20 degrees, turn patient q2h, range of motion exercises qid, Foley catheter, eggcrate mattress. Guaiac stools.

-Keep room dark and quiet; strict bedrest. Neurologic checks q1h for 12 hours, then q2h for 12 hours, then q4h. Call physician if abrupt change in neurologic status.

-Restrict total fluids to 1000 mL/day; diet as tolerated.

-Nimodipine (Nimotop) 60 mg PO or via NG tube q4h for 21d, must start within 96 hours.

-Phenytoin (seizures) load 15 mg/kg IV in NS (infuse at max 50 mg/min), then 300 mg PO/IV qAM (4-6 mg/kg/d).

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