Hemostasis Today
NewsFeed
Headlines Hematology Health Medicine VTE ASH Plasma Donation
June, 2026
June 2026
M T W T F S S
1234567
891011121314
15161718192021
22232425262728
2930  
Ameneh Eshghinejad: The First 72 Hours After SAH Are Critical for Balancing the Risks of Rebleeding and Thromboembolism
Ameneh Eshghinejad/LinkedIn
Apr 23, 2026, 17:19

Ameneh Eshghinejad: The First 72 Hours After SAH Are Critical for Balancing the Risks of Rebleeding and Thromboembolism

Ameneh Eshghinejad, Intensive Care Nurse at Milad hospital, shared a post on LinkedIn:

”The 72-Hour Rule After SAH… is not just a timeline. It’s a decision that can change a life.

In the ICU, we live in the space between two risks:

Rebleeding… versus Thromboembolism

After an aneurysmal subarachnoid hemorrhage (SAH), the question isn’t if anticoagulation is needed – it’s when it becomes safe enough.

And that’s where many clinicians hesitate.

Here’s the practical bedside approach:

0–24 hours:

No anticoagulation.

Mechanical prophylaxis only (IPC).

Your priority equals protect the brain.

24–48 hours:

Start VTE prophylaxis (low-dose heparin or enoxaparin)

Only if:

  • No active bleeding
  • Imaging is stable

Greater than or equal to 72 hours:

Now we reassess everything.

If the patient is:

  • Aneurysm secured (clipped/coiled)
  • Clinically and radiologically stable
  • No hematoma expansion

This is your green light for therapeutic anticoagulation.

The Bedside Rule you should never forget:

Secured plus Stable plus 72 hours equals Go (carefully)

But here’s the part we don’t always talk about…

I once cared for a patient post-SAH—young, previously healthy.
We delayed anticoagulation, fearing rebleeding.

On day 4, everything looked ‘stable.’
But before escalation… they developed a massive pulmonary embolism.

That moment stays with you.

Because in critical care, waiting is also a decision.
And sometimes… it costs more than acting.

This is why precision matters.

Not just protocols. Not just guidelines.

But clinical judgment, timing, and courage to reassess.”

Ameneh Eshghinejad: The First 72 Hours After SAH Are Critical for Balancing the Risks of Rebleeding and Thromboembolism

Stay updated with Hemostasis Today.

Ameneh Eshghinejad bleeding disorders Health Hematology Hemostasis Hemostasis News Hemostasis Today Medicine Rebleeding thromboembolism thrombosis
NewsFeed