A 55-year-old man is brought to the emergency department following onset of sudden severe headache followed by a brief episode of “blacking out” which was witnessed by his wife. He is currently alert and complaining of a diffuse headache and neck pain which he ranks as 7/10 accompanied by some nausea and an episode of vomiting. He has a blood pressure of 170/100 and a HR of 95. On ECG there is evidence of deep wide precordial invert T waves and prolonged QT intervals. What is the best next step at this time?

About the Author: Anton Helman

Dr. Anton Helman is an Emergency Physician at North York General in Toronto. He is an Assistant Professor at the University of Toronto, Division of Emergency Medicine and the Education Innovation Lead at the Schwartz-Reisman Emergency Medicine Instititute. He is the founder, editor-in-chief and host of Emergency Medicine Cases.