Analysis of Headache Management in a Busy Emergency Room in the United States

Sahai‐Srivastava, Soma; Desai, Parth Rakesh; Zheng, Ling

doi:10.1111/j.1526-4610.2008.01156.x

Cited by 42 publications

(43 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This goes in line with other studies reporting a female–male sex ratio between 2:1 [6, 8, 13] and 3:1 [9, 14, 15]. Even though the overall VAS pain score was high (almost 50% of patients rated their headache with a score higher or equal to 7), female patients rated their headache intensity with a higher score than male.…”

Section: Discussionsupporting

confidence: 91%

“…The high percentage (27.7%) of patients suffering from headache NOS in our study may be considered high, as in other reports, the incidence of primary headaches in the EDs reaches 64 [19], 80 [11] and 81.2% [20] and headache NOS was diagnosed in 14.9 [14] or 26% [6] of all headache patients only. However, other studies report a higher incidence of headache NOS, ranges from 42% [15, 16] to 59% [17]. Even in well structured reports from the US, a relevant portion of the primary headaches could not be classified, and therefore, 20% [19] to 36% [13] of the acute patients were not given a diagnosis in the ED.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Headache patients in the emergency department of a Greek tertiary care hospital

et al. 2009

View full text Add to dashboard Cite

The aim of this study was to record the demographic and epidemiological data on adult patients with headache who attend the emergency department (ED) and the diagnoses that made by the neurologists in the ED of a tertiary care hospital in metropolitan Thessaloniki (Greece). In an open prospective study, demographic and epidemiological data were collected on all patients who reported headache (as chief complaint or not) and presented to the ED of Papageorgiou Hospital between August 2007 and July 2008. Headache patients accounted for 1.3% of all ED patients and for 15.5% of patients primarily referred to the ED neurologist. Tension type headache was the most frequent diagnosis, followed by secondary headaches and migraine. The large number of patients without final ED diagnosis and ward admission for further evaluation sheds a light on the immense workload of Greek ED physicians. Furthermore, we found evidence for the misuse of Emergency Medical Services by chronic headache patients. These findings indicate shortcomings in the pre-hospital (primary care) management of headache patients in the Greek National Health System to an extent unreported so far.Electronic supplementary materialThe online version of this article (doi:10.1007/s10194-009-0178-3) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Headache patients in the emergency department of a Greek tertiary care hospital

et al. 2009

View full text Add to dashboard Cite

show abstract

“…In headache patients, the frequency of a serious secondary cause has been reported to be 5-15% [4,5]. It is particularly increased in patients reporting headache with a sudden onset and a high intensity ('worst ever') [6,7].…”

Section: Introductionmentioning

confidence: 98%

Headache in the emergency room: the role of immigrant background on the frequency of serious causes and diagnostic procedures

2011

View full text Add to dashboard Cite

Headache is the most frequent neurological chief complaint in the emergency room (ER). During diagnostic workup, accurate history taking still is the mainstay for identification of patients with a serious underlying disorder. However, in patients with an immigrant background, language problems and cultural influences on pain perception and pain-associated behavior can pose serious challenges for physicians. Here, we have evaluated the epidemiological characteristics of the chief complaint headache in ER patients with a probable immigrant background. We performed a retrospective study on 4,132 consecutive neurological ER patients. Identification of patients with probable immigrant background was done by a name based algorithm. Epidemiological characteristics of ER headache patients with and without probable immigrant background were evaluated. Patients with a probable immigrant background had a higher frequency of headache as chief complaint compared to age- and sex-matched control patients (32 vs. 21%). In addition, headache patients with a probable immigrant background had a lower frequency of serious causes (5.2 vs. 16%). Approximately eight cranial imaging procedures and three lumbar punctures were performed for one serious diagnosis in patients with a probable immigrant background. In control patients, these ratios were three and one, respectively. Taken together, our data suggest that socio-cultural factors such as migrational status significantly affect pain-associated behavior of headache patients as well as the clinical workup in an ER. Culturally competent care may be optimized by interpreters, standardized headache questionnaires and easy access to cranial imaging when a benign etiology cannot be firmly established.

show abstract

“…When life-threatening causes of headache have been ruled out, the goal of headache treatment in the ED becomes pain management (Trainor & Minor, 2008). However, an inaccurate diagnosis of the primary headache disorder, or the lack of diagnosis, inhibits the ability of the ED practitioner to effectively treat the patient's headache exacerbation (Sahai-Srivastava, Desai, & Zheng, 2008). However, an inaccurate diagnosis of the primary headache disorder, or the lack of diagnosis, inhibits the ability of the ED practitioner to effectively treat the patient's headache exacerbation (Sahai-Srivastava, Desai, & Zheng, 2008).…”

Section: Managementmentioning

confidence: 99%

Primary Headache Disorders in the Emergency Department

Lange¹

2011

Advanced Emergency Nursing Journal

View full text Add to dashboard Cite

Headache is 1 of the 5 most common chief complaints in the United States and accounts for nearly 5 million visits in the emergency department (ED; B. Freidman, D. Serrano, M. Reed, M. Diamond, & R. Lipton, 2009). Despite the number of patients admitted to EDs with a headache, there appears to be a lack of consensus among practitioners as how best to treat primary headache disorder in this patient population. Current research has taken into consideration the specific factors that contribute to ED visits by patients with headaches. This research has identified the need for standardized practice protocols for the treatment of headaches in the ED. In addition, research has focused on new strategies of pain management that takes into account the chronicity of headaches. This article focuses on an important consideration in the management of primary headache disorders provided by ED clinicians-the prevention of headache recurrence through thorough patient education and the identification and modification of risk factors.

show abstract

Analysis of Headache Management in a Busy Emergency Room in the United States

Cited by 42 publications

References 18 publications

Headache patients in the emergency department of a Greek tertiary care hospital

Headache patients in the emergency department of a Greek tertiary care hospital

Headache in the emergency room: the role of immigrant background on the frequency of serious causes and diagnostic procedures

Primary Headache Disorders in the Emergency Department

Contact Info

Product

Resources

About