Migrane Headache Treatment in the ED - page 2

I'm doing a reasearch project and am looking ofr information on how other hospitals are treting Migrane patients. What drugs are you using and why? Do you have any written protocols or a no... Read More

  1. by   scotto71
    Hi from Australia,

    We are currently using chlorpromazine as an IV infusion in NSaline 1000ml. It is often preceded by a fluid bolus of 500 - 1000cc, as chlopromazine often causes hypotension. The usual dose is 12.5 - 25mg in a 1000cc bag saline over 1 hour. So far - no reported incidences of it failing!

    Scott
  2. by   kaycee
    Along with the others meds already listed some of our Docs use high flow O2 and that seems to make a difference sometimes.
  3. by   theboss
    we seldom give narcotics.. we have what we call the DEW. compazine 10mg and decadron 20 mg.. slow iv push over 5 minutes. start with the compazine..and once in a while a doc will use benadryl and inapsine..but 99% of the time the compazine and decadron will work..if not they want narcs.its said that the compazine and decadron relieve the pressure..
  4. by   Kathy L. RN
    At our ED our doctors usually use Compazine 10 mg diluted in 50 cc NS over 10-15 minutes and it usually works for those who have true migraines. Personally, I love Imitrex cause it works so well for the migraines I get.
  5. by   vablueyes
    I suffer from occasional migraines, and can almost always relate them to the weather. If the barometric changes suddenly, I'll get a migraine. Knowing this, I have begun to encourage my migraine patients to keep a log of their headaches, and to check what the barometric is doing when they have them. Suprise!! Our frequent flyer migrainers has decreased. We still have the seekers, but the legit migraines have decreased remarkably.
  6. by   prmenrs
    Dumb ?? from a NICU nurse--why does the NSS help? Thanks
  7. by   teeituptom
    Howdy Yall
    From deep in the heart of Texas

    We see a lot of migrainers here also. But the hospital and ED have no set policy on the issue of drug preference for the migraine patient. Its up to the individual MDs preference. You can almost tell where a doctor went to school by the way he treats them. Ive seen every possible combination of drugs and treatments used. everything from one doctor asking what the pt wanted to recieve, I have one doctor who loves to reglan everybody along with a NS bolus. I have one who uses decadron,toradol,and O2 on everybody. One who just writes scripts for stadol sniffers and sends them out the door.
    We dont have a no narcotics policy here. But that is not to say if a pt is too frquent the doctor just gives them a couple of tylenol and sends them home. But even that is variable to the individual doctor. Its kind of like the pt getting the luck of the draw on who picks up their chart. Will I win the lottery tonight or will I get zip.

    keep it in the short grass yall
    teeituptom
  8. by   KKERRN
    Just treated one recently with Stadol 2 mg,Benadryl 50 mg IV and Thorazine 30 mg in 250 cc NS over one hour. This worked well for this patient.
    We used to use compazine, but hospital quit stocking it due to cost.
  9. by   CEN35
    well for us it's because there is a compazine shortage. that has always worked well. except for the epse's.

    me
  10. by   DanRn
    we have had good success with droperidol and benedryl.
  11. by   2ndCareerRN
    We have just started using dilaudid supposotories. some have left without their narcs, while the ones that we have used them on have reported very good relief. The nice thing is that is is supposed to relieve the HA without the high associated with the other IV/IM narcs that we used to use. Hummm...could be why some people leave with their "migraine", rather than allow us to treat with a supp.

    bob
  12. by   AngelGirl
    prmenrs

    I believe that NSS means Normal Saline Solution :angel2:
  13. by   angelbear
    I too suffer with migraines. Being a nurse myself I know alot think FF right off the bat. Unfortunately because of this I tend to wait too long. For me it is usually only after hours of agony and every OTC known to man that I go to ER. Toradol does not work dont know why. Very glad to hear about dilauded supps. I have never been offered that. If it is true that you dont get the "high" with them that would be great as I do get that tunnel thing which freaks me out. I hate that feeling. I wonder, can you request that instead of IM or is it not commonly on hand.

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