Adult Headache

Question 1

Headache ‘STOP’ Contras

Answer 1

Intracranial Haemorrhage
Stroke/TIA
Seizure
Meningococcal Septicaemia

Question 2

Tx for cluster headaches

Answer 2

10-15L/min NRB regardless of SpO2

Question 3

Sudden onset thunderclap headache suspicions

Answer 3

serious intracranial event

Question 4

Tx for headaches

Answer 4

Paracetamol 1g (500mg for frail elderly, 15mg/kg paeds)

Stemetil regardless of severity 12.5mg

If severe headache after 15/60 and still 15/60 from hospital Fentanyl IN/IV aiming for pain score <7.

Question 5

Stemetil Indications

Answer 5

Nausea and vomiting in patient ≥ 21 years of age; specifically for
- Known allergy or C/I to ondansetron
- Vestibular nausea
Headache (irrespective of nausea / vomiting)

Question 6

Stemetil COntras

Answer 6

CNS depression (i.e. unconscious or severely intoxicated)
Patients < 21 years of age.
Children and young adults are more susceptible to extrapyramidal reactions with
prochlorperazine.

Question 7

Stemetil Precautions

Answer 7

Elderly patients - More susceptible to adverse effects
Parkinson’s disease - Can worsen symptoms of Parkinson’s disease, avoid if possible

Question 8

Stemetil Side Effects

Answer 8

CNS: Sedation, blurred vision
CV: Postural hypotension, QT prolongation (rare)
Other: Extrapyramidal reactions