I’ve always stayed away from NSAIDs in anyone that could have a brain bleed, including alot of people who I’m 99% sure don’t have a bleed but do have a new headache. I know there’s an FDA warning on the box stating not to give toradol in patients with suspected cerebrovascular bleeding. However, when I tried reading up on it, the literature really only looks at people with long term NSAID use and even then the results aren’t always consistent. Some papers even showed reduced incidence of secondary injury from hemorrhagic stroke in the setting of NSAID use.
With all of that being said, I was just curious on your practice from a liability standpoint. If someone comes in with a headache that you’re not overly concerned for a subarachnoid or after low mechanism trauma, you give some toradol, and then they come back tomorrow and a bleed is found on CT, how screwed are you?