Adult Headache

Question 1

Can paramedics diagnose headaches?

Answer 1

-No, it is dependent on an in-hospital diagnosis

Question 2

Can aspirin be administered for a headache?

Answer 2

• No

Question 3

If the headache is considered severe or to be a migraine other than pain reflief what medication can be administered?

Answer 3

• Stemitil

Question 4

Warnings signs that may be suggestive of a serious intracranial event include (6things)

Answer 4

• Sudden onset Thunderclap/Worst headache
• Abnormal neurological findings or atypical aura
• New onset headache in older patients >50 or those with a history of cancer
• Alteredm level of consciousness or collapse
• Seizure activity
• Fever and/or neck stiffness

Question 5

What types of headaches are there?

Answer 5

• Rebound (On the sides)
• Sinus (X in from of nose, in the sinuses)
• Exertion headaches (around the head)
• Migraines (Half the head)
• Cluster (Behind the eye(
• Tension (Forhead)

Question 6

If patient presenting with severe headache AND suspected intracranial Haemorrhage what should the patient be treated under

Answer 6

• Severe Headache

Question 7

What is the initial management for a headache

Answer 7

• 1g Paracetamol
• 500mg from <60kg, frail, Elderly, malnourished, liver disease
• 12.5mg IM Stemitil

Question 8

When do you treat a headache as severe

Answer 8

• After 15minutes AND if hospital is still 15minutes away

Question 9

What is the severe headache management

Answer 9

• 50mcg IV, 200mcg IN, 100mcg IM Fentanyl
• 25mcg IV, 100mcg IN, 1mcg/kg IM Fentanyl if <60kg, frail, elderly)
• Aim to reduce pain to <7