• The patient who is regaining consciousness should be on the intra venous fluids which may already be running , blood transfusion may be added if required , and pain killers should be limited to NSAIDS given as suppositories.
    The intra venous route for drugs and nourishment. should be continued for at least 6 hours after regaining consciousness.

    Pressure maintaining drugs too should be given parenterally.

    Narcotic analgesics are contraindicated.

  • Tylenol would be the best choice. Even after imaging studies, it’s going to be important to watch for further neurologic symptoms, and narcotics will obscure the picture. How would you know if nausea or drowsiness is from increased intracranial pressure or just from the drug? And of lesser concern, but still to be considered, is that aspirin and NSAID’s like ibuprofen decrease platelet aggregation. They would be difficult to justify having given in the patient who subsequently winds up with an expanding subdural hematoma, for instance. That leaves you with acetaminophen/paracetamol.
    Even the simplest of things can turn out to be complicated, can’t they?

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