Book contents
- Frontmatter
- Contents
- Acknowledgments
- List of Contributors
- SECTION ONE OVERVIEW AND PRINCIPLES IN EMERGENCY ANALGESIA AND PROCEDURAL SEDATION
- SECTION TWO ANALGESIA FOR THE EMERGENCY PATIENT
- 8 Pharmacology of Commonly Utilized Analgesic Agents
- 9 Patient Assessment: Pain Scales and Observation in Clinical Practice
- 10 Pathways and Protocols for the Triage Patient with Acute Pain
- 11 Patients with Acute Pain: Patient Expectations and Desired Outcomes
- 12 Analgesia for the Adult and Pediatric Multitrauma Patient
- 13 Analgesia for the Emergency Department Isolated Orthopedic Extremity Trauma Patient
- 14 Analgesia for Selected Emergency Eye and Ear Patients
- 15 Analgesia for the Emergency Headache Patient
- 16 Analgesia for the Emergency Chest Pain Patient
- 17 Analgesia for the Emergency Back Pain Patient
- 18 Analgesia for the Acute Abdomen Patient
- 19 Analgesia for the Renal Colic Patient
- 20 Analgesia for the Biliary Colic Patient
- 21 Analgesia for the Chronic Pain Patient
- 22 Outpatient Analgesia following Acute Musculoskeletal Injury
- SECTION THREE PROCEDURAL SEDATION FOR THE EMERGENCY PATIENT
- SECTION FOUR TOPICAL, LOCAL, AND REGIONAL ANESTHESIA APPROACH TO THE EMERGENCY PATIENT
- SECTION FIVE SPECIAL CONSIDERATIONS FOR EMERGENCY PROCEDURAL SEDATION AND ANALGESIA
- Index
- Plate section
- References
15 - Analgesia for the Emergency Headache Patient
from SECTION TWO - ANALGESIA FOR THE EMERGENCY PATIENT
Published online by Cambridge University Press: 03 December 2009
- Frontmatter
- Contents
- Acknowledgments
- List of Contributors
- SECTION ONE OVERVIEW AND PRINCIPLES IN EMERGENCY ANALGESIA AND PROCEDURAL SEDATION
- SECTION TWO ANALGESIA FOR THE EMERGENCY PATIENT
- 8 Pharmacology of Commonly Utilized Analgesic Agents
- 9 Patient Assessment: Pain Scales and Observation in Clinical Practice
- 10 Pathways and Protocols for the Triage Patient with Acute Pain
- 11 Patients with Acute Pain: Patient Expectations and Desired Outcomes
- 12 Analgesia for the Adult and Pediatric Multitrauma Patient
- 13 Analgesia for the Emergency Department Isolated Orthopedic Extremity Trauma Patient
- 14 Analgesia for Selected Emergency Eye and Ear Patients
- 15 Analgesia for the Emergency Headache Patient
- 16 Analgesia for the Emergency Chest Pain Patient
- 17 Analgesia for the Emergency Back Pain Patient
- 18 Analgesia for the Acute Abdomen Patient
- 19 Analgesia for the Renal Colic Patient
- 20 Analgesia for the Biliary Colic Patient
- 21 Analgesia for the Chronic Pain Patient
- 22 Outpatient Analgesia following Acute Musculoskeletal Injury
- SECTION THREE PROCEDURAL SEDATION FOR THE EMERGENCY PATIENT
- SECTION FOUR TOPICAL, LOCAL, AND REGIONAL ANESTHESIA APPROACH TO THE EMERGENCY PATIENT
- SECTION FIVE SPECIAL CONSIDERATIONS FOR EMERGENCY PROCEDURAL SEDATION AND ANALGESIA
- Index
- Plate section
- References
Summary
SCOPE OF THE PROBLEM
Headaches present a frequent diagnostic and therapeutic challenge to emergency physicians. In fact, it is estimated that patients with the complaint of headache account for 1–2% of all emergency department (ED) visits. Primary headache, also known as “benign headache,” is a headache that is not “secondary” to some identified discrete pathology (e.g., meningitis, sinusitis, subarachnoid hemorrhage, toothache, etc.). The ED evaluation of headache is twofold: first, to determine whether the headache is primary (Table 15-1) or secondary (Table 15-2), and then, if primary, to relieve the patient's pain, and if secondary, to treat the underlying condition.
The International Headache Society (IHS) has established several definitions for classifications of primary headaches. Although these remain useful in determining long-term treatment strategies, most ED patients present with undifferentiated headaches. These include migraine, probable migraine, episodic tension type, and cluster headaches. For the practical purpose of ED evaluation, ED patients with headache may be classified as serious or benign after the initial evaluation. The benign causes of headache (primary headaches) have been reported to account for up to 90% of ambulatory patients presenting with a complaint of headache. Since the further differentiation of the headache before treatment is unlikely to occur in the ED setting, treatment strategies must take into account the full range of headache subtypes and the evolving nature of the diagnosis of a patient's headache pain.
It has been estimated that 12% of the population has had a migraine headache.
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- Chapter
- Information
- Emergency Sedation and Pain Management , pp. 96 - 102Publisher: Cambridge University PressPrint publication year: 2008