Refer a patient with suspected subarachnoid haemorrhage urgently to secondary care for assessment and investigation, particularly if they present with symptoms such as unexplained thunderclap headache, neck pain or stiffness, photophobia, nausea and vomiting, or new signs of altered brain function, including reduced consciousness, seizure, or focal neurological deficit NICE NG228.
If a person with suspected subarachnoid haemorrhage is seen outside of acute hospital settings, they should be referred immediately to an emergency department for further assessment NICE NG228.
In acute hospital settings, review by a senior clinical decision-maker is recommended to assess the person and consider alternative diagnoses before proceeding with investigations NICE NG228.