Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Headache
| Autor: | Steven A. Godwin, David S. Cherkas, Peter D. Panagos, Richard D. Shih, Richard Byyny, Stephen J. Wolf, Christopher R. Carpenter, Deborah B. Diercks, Seth R. Gemme, Charles J. Gerardo, Sigrid A. Hahn, Nicholas E. Harrison, Benjamin W. Hatten, Jason S. Haukoos, Amy Kaji, Heemun Kwok, Bruce M. Lo, Sharon E. Mace, Devorah J. Nazarian, Jean Proehl, Susan B. Promes, Kaushal H. Shah, Scott M. Silvers, Michael D. Smith, Molly E.W. Thiessen, Christian A. Tomaszewski, Jonathan H. Valente, Stephen P. Wall, Stephen V. Cantrill, Jon M. Hirshon, Travis Schulz, Rhonda R. Whitson |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Evidence-Based Medicine Adult patients Computed Tomography Angiography Headache Disorders business.industry Emergency department Subarachnoid Hemorrhage Cerebral Angiography Analgesics Opioid Risk Factors Family medicine Acute Disease Emergency Medicine medicine Humans Female Emergency Service Hospital business Facilities and Services Utilization |
| Zdroj: | Annals of Emergency Medicine. 74:e41-e74 |
| ISSN: | 0196-0644 |
| Popis: | This clinical policy from the American College of Emergency Physicians addressed key issues in the evaluation and management of adult patients presenting to the emergency department with acute headache. A writing subcommittee conducted a systematic review of the literature to derive evidence-based recommendations to answer the following clinical questions: (1) In the adult emergency department patient presenting with acute headache, are there risk-stratification strategies that reliably identify the need for emergent neuroimaging? (2) In the adult emergency department patient treated for acute primary headache, are nonopioids preferred to opioid medications? (3) In the adult emergency department patient presenting with acute headache, does a normal noncontrast head computed tomography scan performed within 6 hours of headache onset preclude the need for further diagnostic workup for subarachnoid hemorrhage? (4) In the adult emergency department patient who is still considered to be at risk for subarachnoid hemorrhage after a negative noncontrast head computed tomography, is computed tomography angiography of the head as effective as lumbar puncture to safely rule out subarachnoid hemorrhage? Evidence was graded and recommendations were made based on the strength of the available data. |
| Databáze: | OpenAIRE |
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