Question: I recently did a transfer with a physician going to LHSC University Hospital with a confirmed subarachnoid bleed. The patient was conscious, conversed and was oriented x 3. They were mildly lethargic, c/o an occipital headache with no neuro deficits. The physician accompanied the patient to give a medication to keep the BP on or around 140 systolic.

During transport, the patients BP began to rise to 160-180 because of nausea and vomiting. Gravol was administered and a drug (sorry, I can’t recall the name).

He asked me if we carried anything that could drop the BP. He suggested Nitro. I know this is not listed as a contraindication but would it be wise to give a vaso dilator to a patient with a cerebral bleed. We did not administer nitro, but the question still remains. Thanks in advance.