A young woman came in by ambulance. She awoke at 11 pm out of a deep sleep because of a headache that swept up from the back of her neck up over the top of her skull. She sat up, called out to her husband, and vomited in the bed. He called an ambulance.
In triage she was alert and oriented, pupils equal and reactive, able to move all of her extremities, but seemed...off. She vomited three more times, and said, "This is the worst headache of my life. I've never had a headache like this."
Uh oh. That's a line straight from the textbook.
Straight to the CT scanner, and BINGO! A bleed, heading on down to the pons. We called neurosurgery and medicated her for pain and nausea. The doctor told her she'd have to go to surgery, and she asked for a phone to call her husband. By that time she was a little out of it. "Honey? They say I'm bleeding in my brain. Yeeeaaaahhh....it's not a big deal....some kind of surgery, probably. No, no....you stay home with the kids. I'm OK....it's not a big deal, honey...what? The nurse is right here....okay..." She holds the phone out to me. "He doesn't believe that this isn't a big deal." I took the phone.
"Sir? This is GuitarGirl RN, your wife's nurse. Yes, it's a big deal. I'll give you to the doctor, he can explain exactly what's going on."
She ended up being fine, thank goodness.