13th August 2024

A 48-year-old gentleman has presented to A&E with a severe right-sided headache

A 48-year-old gentleman has presented to A&E with a severe right-sided headache. The pain is excruciating and he is unable to give you a full history as he is agitated and pacing around the department. You can see in his history that he has suffered with headaches for the past 5 years and is usually treated with high flow oxygen which successfully resolves his symptoms. His past medical history includes ischaemic heart disease, hypertension, high cholesterol and gastro-oesophageal reflux disease. The A&E doctor has administered high flow oxygen however his symptoms have not improved. On examination, his right eye is very red and watery. His heart rate is 110 bpm and his blood pressure is 180/90 mmHg.

Which treatment should be started to treat his symptoms acutely?

Select the SINGLE most appropriate option from the list below. Select ONE option only.