SAH ICU Note Template & Daily Plan Builder
A SAH ICU note builder for residents: grade, aneurysm status and post-bleed day in; the vasospasm-window plan and ICU checklist out.
Reviewed by Zaka Ahmed, MD Clinical reference · 4 min read
SAH ICU Note Builder
⚠ Do not enter names, dates of birth, MRNs, or any other identifier. Nothing is stored on our servers.Educational documentation aid for clinicians. It applies published guideline logic to what you enter; it does not know your patient. Verify every line, follow your institutional protocol, and use clinical judgment. Full disclaimer. All builders in one place: the residents’ workspace.
Assistant (beta)
Type or dictate your one-line impression and the assistant fills the fields above; the plan itself still comes from the rule set, not from the model. No identifiers — the text goes to our own server and on to a language-model provider, and is not stored.
My phrases — the builder learns your service
Add the lines your attending always wants. Saved in this browser only and appended to the section you choose every time you build this note.
Clinical notes & interpretation Scoring guidance, pitfalls, FAQs, and references
A SAH ICU note is a calendar: what day it is after the bleed decides what you are watching for.
- → Post-bleed day places the patient inside or outside the days 3–14 delayed cerebral ischemia window, and the surveillance lines change accordingly.
- → Aneurysm status decides the blood-pressure section: SBP under 160 with no antithrombotics until secured, liberalized once coiled or clipped.
- → Sodium, EVD, and airway toggles add exactly the lines that patient needs — hyponatremia without fluid restriction, ICP and CPP targets, lung-protective ventilation — and nothing else.
The daily SAH checklist, written for you
Nimodipine dose and stop date, euvolemia (no prophylactic hypervolemia), daily transcranial Dopplers in the window, the response to clinical delayed cerebral ischemia (induced hypertension and endovascular rescue), fever control, glucose, VTE prophylaxis timing relative to securing the aneurysm, and the family update — each is a line the builder writes from a toggle. The result reads like the note a senior fellow would write on rounds, in the order the ICU team actually reviews.
Grade is not destiny
The builder carries the guideline reminder that poor-grade patients can recover and that early withdrawal on the basis of grade alone is discouraged. It also handles the angio-negative case correctly: a perimesencephalic pattern carries an excellent prognosis but still needs the repeat vascular study at about a week.
Where this fits with the other builders
ICH with intraventricular extension, post-thrombectomy ICU care, status epilepticus, and myasthenic crisis have their own builders in the residents' workspace; the engine is shared, so preferences and saved phrases carry across.
Frequently asked questions
Does the builder change the plan for an unsecured aneurysm?
Yes. It writes the securing-first line (coil or clip, ideally within 24 hours), the pre-securing SBP target under 160, no antithrombotics, and no routine antifibrinolytic; once you mark the aneurysm coiled or clipped, the blood-pressure section liberalizes and the VTE prophylaxis line advances.
What does the builder do with a low sodium?
It writes the SAH-specific answer: do not fluid-restrict; use salt tablets or hypertonic saline; assess volume status to separate cerebral salt wasting from SIADH; and consider fludrocortisone. Very low values are flagged.
Is this a substitute for my unit's SAH protocol?
No. It is an educational documentation aid that applies published guideline logic to what you enter. Institutional targets, agents, and monitoring schedules come first, and every line is editable.
References
- Hoh BL, et al. 2023 guideline for the management of patients with aneurysmal subarachnoid hemorrhage. Stroke. 2023;54:e314–e370.
- Molyneux AJ, et al. International Subarachnoid Aneurysm Trial (ISAT). Lancet. 2002;360:1267–1274.
- Pickard JD, et al. Effect of oral nimodipine on cerebral infarction and outcome after subarachnoid haemorrhage (BRANT). BMJ. 1989;298:636–642.
- Post R, et al. Ultra-early tranexamic acid after subarachnoid haemorrhage (ULTRA). Lancet. 2021;397:112–118.
Related reading
From the articles.
- Types of stroke explained Subarachnoid hemorrhage among the hemorrhagic strokes.