Nursing Care Strategies for Subarachnoid Hemorrhage: Comprehensive Patient Support and Recovery Tips

Understanding Subarachnoid Hemorrhage and Its Impact on Patient Care

Subarachnoid hemorrhage (SAH) is a serious medical condition characterized by bleeding into the space surrounding the brain. The most common symptoms include sudden, severe headaches often described as "the worst headache of one's life," along with nausea and vomiting. These neurological events can lead to prolonged hospitalization and extended bed rest, making comprehensive nursing care essential for recovery and complication prevention.

Optimal Positioning and Respiratory Management

Proper patient positioning plays a critical role in managing intracranial pressure and enhancing comfort. Nurses are advised to elevate the head of the bed by 15° to 20° to facilitate venous drainage from the brain and reduce pressure. In addition, placing the patient in a lateral (side-lying) position helps prevent aspiration and supports airway patency. Maintaining an open and clear airway is vital—especially in unconscious patients—who may require regular suctioning of secretions or even intubation or tracheostomy if respiratory compromise occurs.

Preventing Pulmonary Complications

Pulmonary hygiene is a cornerstone of post-hemorrhage care. Due to limited mobility and potential decreased consciousness, patients are at high risk for pneumonia and atelectasis. Routine back tapping (chest physiotherapy), frequent repositioning, and incentive spirometry help expand lung capacity. Nebulizer treatments are also commonly used to loosen mucus and keep the lungs clear, significantly lowering the risk of respiratory infections during recovery.

Nutritional Support and Gastrointestinal Care

Nutrition is another key component of effective SAH management. For patients who are unconscious or unable to swallow safely, nasogastric (NG) tube feeding provides a reliable method for delivering essential nutrients directly to the stomach. A balanced enteral formula supports immune function, tissue repair, and overall metabolic stability. Additionally, a light, liquid-based diet is recommended for those able to eat orally, minimizing gastrointestinal strain while ensuring hydration and nutrient intake.

Ensuring Bowel Regularity

Constipation is a common issue due to immobility, medication side effects (such as opioids), and reduced oral intake. To promote regular bowel movements and avoid straining—which could increase intracranial pressure—patients should be encouraged to maintain adequate fluid intake and may benefit from stool softeners or mild laxatives under medical supervision. A consistent toileting schedule and dietary fiber adjustments further support digestive health.

Skin Integrity and Pressure Injury Prevention

Extended bed rest increases the risk of pressure ulcers, especially in paralyzed or comatose individuals. Nurses must implement a strict turning schedule—ideally repositioning the patient every two hours—to relieve pressure on vulnerable areas such as the sacrum, heels, and hips. Using specialized mattresses, keeping skin clean and dry, and routine skin assessments are all part of a proactive strategy to prevent skin breakdown and infection.

The Role of Early and Ongoing Rehabilitation

As patients stabilize, early engagement in rehabilitation becomes crucial. Physical therapy helps maintain joint mobility and muscle strength, while occupational therapy supports functional independence. Speech therapy may also be necessary if the hemorrhage has affected communication abilities. A multidisciplinary approach ensures that recovery extends beyond survival to include improved quality of life and long-term neurological outcomes.

Conclusion: Holistic Nursing Care for Better Outcomes

Caring for patients with subarachnoid hemorrhage requires a coordinated, patient-centered approach. From maintaining airway and nutritional support to preventing complications like pneumonia and bedsores, nurses play a pivotal role in every stage of recovery. By combining evidence-based practices with compassionate, attentive care, healthcare teams can significantly enhance healing, reduce hospital stays, and support patients on their journey back to health.