Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Headache: Approved by the ACEP Board of Directors June 26, 2019 Clinical Policy Endorsed by the Emergency Nurses Association (July 31, 2019).

Published

Journal Article (Review)

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.

Full Text

Duke Authors

Cited Authors

  • American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Acute Headache:, ; Godwin, SA; Cherkas, DS; Panagos, PD; Shih, RD; Byyny, R; Wolf, SJ

Published Date

  • October 2019

Published In

Volume / Issue

  • 74 / 4

Start / End Page

  • e41 - e74

PubMed ID

  • 31543134

Pubmed Central ID

  • 31543134

Electronic International Standard Serial Number (EISSN)

  • 1097-6760

Digital Object Identifier (DOI)

  • 10.1016/j.annemergmed.2019.07.009

Language

  • eng

Conference Location

  • United States