Practical Assessment and Treatment of the Patient with Headaches in the Emergency Department and Urgent Care Clinic

Nonfiction, Health & Well Being, Medical, Specialties, Emergency Medicine, Internal Medicine, Neurology
Cover of the book Practical Assessment and Treatment of the Patient with Headaches in the Emergency Department and Urgent Care Clinic by Dawn A. Marcus, Philip A. Bain, Springer New York
View on Amazon View on AbeBooks View on Kobo View on B.Depository View on eBay View on Walmart
Author: Dawn A. Marcus, Philip A. Bain ISBN: 9781461400028
Publisher: Springer New York Publication: July 29, 2011
Imprint: Springer Language: English
Author: Dawn A. Marcus, Philip A. Bain
ISBN: 9781461400028
Publisher: Springer New York
Publication: July 29, 2011
Imprint: Springer
Language: English

Migraine is an extremely common condition affecting 28 million Americans. Fully 1 in every 6 adult women suffers from this malady. Patients with migraine are frequently seen in the Emergency Room and Urgent Care Clinic for acute treatment of their headaches. Headache generally accounts for nearly 3 % of all ER visits, resulting in almost 3.5 million visits annually.

 

There currently are no widely used guidelines for the treatment of patients with headache in the ER or UCC, and reducing the number of CT scans remains a key goal for administrators in many ER or urgent care settings. In one study, 35 drugs, alone or in combination, were used to treat migraine. The most common medication class used was narcotics, which were used in 25% of the visits. The next two most commonly used classes were antiemetics and NSAIDs.  Only 5% of patients seen for headache received headache-specific medications during their visit.

 

ER and Urgent Care physicians generally have little or no formal training in treating these patients. Consequently, they often feel less comfortable ruling out secondary causes of headaches and using appropriate headache treatment medications and procedures. Since many patients have received narcotics in previous visits, providers may view them as drug seekers. Patients seen in ERs and UCCs for acute treatment of their headaches often report high levels of dissatisfaction. They often end up in the ER or UCC because they don’t have a formal treatment strategy for their severe headaches.

 

Health plans and insurance agencies are often frustrated by the high cost of fragmented care for patients with headaches. Because of the environment that most ER and UCC providers operate in, many unnecessary scans and tests are done because of uncertainty of the diagnosis and unfamiliarity of the patient.  Primary care physicians are also frustrated by patients with headaches presenting to them after being seen in the ER or UCC, wanting a refill of their narcotics that they were given. Many patients don’t follow up with their PCPs and simply keep returning to the ER/UCC for their treatment.

 

In short, all involved in the care for patients with headache are frustrated by the current system. The care for these patients is clearly not optimal. It doesn’t have to be that way. There are a wide variety of effective treatment options available, but are underutilized in the acute setting. With these treatment options, patients no longer have to be treated only with parenteral narcotics, only to perpetuate the cycle of suboptimal care described above.

 

This concise handbook covers all aspects of acute headache care, including care of the child and adolescent with acute headaches, treatment of pregnant and breastfeeding women with acute headaches and appropriate evaluation of secondary headaches.  In addition, two other novel chapters are included: one on caring for older patients with acute headaches as well as a chapter describing how to ensure a seamless transition of the patient back to a headache interested provider.

 

Representing an important milestone in the care of patients with headache, this is the first concise handbook available to exclusively address the issue of headache treatment in the acute  care setting. Including protocols and strategies that can be used right away, Management of Headaches in Emergency Room and Urgent Care Settings: Diagnosis and Management provides information about lesser known, but effective strategies such as greater occipital nerve blocks that can be easily learned and incorporated in the acute care setting. It emphasizes the continuity of care that is so vital to keep headache patients from returning to the ER and UCC for acute treatment.

View on Amazon View on AbeBooks View on Kobo View on B.Depository View on eBay View on Walmart

Migraine is an extremely common condition affecting 28 million Americans. Fully 1 in every 6 adult women suffers from this malady. Patients with migraine are frequently seen in the Emergency Room and Urgent Care Clinic for acute treatment of their headaches. Headache generally accounts for nearly 3 % of all ER visits, resulting in almost 3.5 million visits annually.

 

There currently are no widely used guidelines for the treatment of patients with headache in the ER or UCC, and reducing the number of CT scans remains a key goal for administrators in many ER or urgent care settings. In one study, 35 drugs, alone or in combination, were used to treat migraine. The most common medication class used was narcotics, which were used in 25% of the visits. The next two most commonly used classes were antiemetics and NSAIDs.  Only 5% of patients seen for headache received headache-specific medications during their visit.

 

ER and Urgent Care physicians generally have little or no formal training in treating these patients. Consequently, they often feel less comfortable ruling out secondary causes of headaches and using appropriate headache treatment medications and procedures. Since many patients have received narcotics in previous visits, providers may view them as drug seekers. Patients seen in ERs and UCCs for acute treatment of their headaches often report high levels of dissatisfaction. They often end up in the ER or UCC because they don’t have a formal treatment strategy for their severe headaches.

 

Health plans and insurance agencies are often frustrated by the high cost of fragmented care for patients with headaches. Because of the environment that most ER and UCC providers operate in, many unnecessary scans and tests are done because of uncertainty of the diagnosis and unfamiliarity of the patient.  Primary care physicians are also frustrated by patients with headaches presenting to them after being seen in the ER or UCC, wanting a refill of their narcotics that they were given. Many patients don’t follow up with their PCPs and simply keep returning to the ER/UCC for their treatment.

 

In short, all involved in the care for patients with headache are frustrated by the current system. The care for these patients is clearly not optimal. It doesn’t have to be that way. There are a wide variety of effective treatment options available, but are underutilized in the acute setting. With these treatment options, patients no longer have to be treated only with parenteral narcotics, only to perpetuate the cycle of suboptimal care described above.

 

This concise handbook covers all aspects of acute headache care, including care of the child and adolescent with acute headaches, treatment of pregnant and breastfeeding women with acute headaches and appropriate evaluation of secondary headaches.  In addition, two other novel chapters are included: one on caring for older patients with acute headaches as well as a chapter describing how to ensure a seamless transition of the patient back to a headache interested provider.

 

Representing an important milestone in the care of patients with headache, this is the first concise handbook available to exclusively address the issue of headache treatment in the acute  care setting. Including protocols and strategies that can be used right away, Management of Headaches in Emergency Room and Urgent Care Settings: Diagnosis and Management provides information about lesser known, but effective strategies such as greater occipital nerve blocks that can be easily learned and incorporated in the acute care setting. It emphasizes the continuity of care that is so vital to keep headache patients from returning to the ER and UCC for acute treatment.

More books from Springer New York

Cover of the book The Social Psychology of Creativity by Dawn A. Marcus, Philip A. Bain
Cover of the book Aerodynamic Noise by Dawn A. Marcus, Philip A. Bain
Cover of the book Operational Modal Analysis of Civil Engineering Structures by Dawn A. Marcus, Philip A. Bain
Cover of the book Hardware/Software Architectures for Low-Power Embedded Multimedia Systems by Dawn A. Marcus, Philip A. Bain
Cover of the book Essentials of Pharmacology for Anesthesia, Pain Medicine, and Critical Care by Dawn A. Marcus, Philip A. Bain
Cover of the book Capacity Analysis of Vehicular Communication Networks by Dawn A. Marcus, Philip A. Bain
Cover of the book Nutrition in Pediatric Pulmonary Disease by Dawn A. Marcus, Philip A. Bain
Cover of the book Bergey's Manual of Systematic Bacteriology by Dawn A. Marcus, Philip A. Bain
Cover of the book Space Physiology and Medicine by Dawn A. Marcus, Philip A. Bain
Cover of the book Muscle Imaging in Health and Disease by Dawn A. Marcus, Philip A. Bain
Cover of the book Emerging Trends in Computing, Informatics, Systems Sciences, and Engineering by Dawn A. Marcus, Philip A. Bain
Cover of the book Work Accommodation and Retention in Mental Health by Dawn A. Marcus, Philip A. Bain
Cover of the book Sustaining the World's Wetlands by Dawn A. Marcus, Philip A. Bain
Cover of the book Astronomy with a Budget Telescope by Dawn A. Marcus, Philip A. Bain
Cover of the book Superficial Liposculpture by Dawn A. Marcus, Philip A. Bain
We use our own "cookies" and third party cookies to improve services and to see statistical information. By using this website, you agree to our Privacy Policy