Migrane Headache Treatment in the ED - page 4

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   berry
    we have a group of MDs for the Er so each one does their own thing but a couple have started with phenergan IV 25mg q five minutes x 3 if needed most pts dont even need the third dose with some pt is knocks out the HA and others they are to groggy to feel it anymore and no real risk of resp dep if the are getting a ct they feel 1000x better laying flat in the bright room and in a urban setting we really hate to treat street with narc it only increases the amount of seekers
  2. by   Liddle Noodnik
    Originally posted by Rhoresmith
    until you have a Headache or watch someone you love suffer from one you should never judge -- Rhonda
    Thanks Rhonda. We should never judge anyway...
  3. by   newfloridaRN
    hollykate- i know since i take imitrex myself its SO expensive......and the thing about taking it at onset of aura. depends what route you're taking. depends if its PO, nasal, or SC...so that's not necessarily the reason..... also....ZOBOBOEY.. never heard of drawing blood thru a saline lock??? ha- what ER do you work in?!?!
  4. by   Liddle Noodnik
    Originally posted by newfloridaRN
    hollykate- i know since i take imitrex myself its SO expensive......and the thing about taking it at onset of aura. depends what route you're taking. depends if its PO, nasal, or SC...so that's not necessarily the reason..... also....ZOBOBOEY.. never heard of drawing blood thru a saline lock??? ha- what ER do you work in?!?!
    It's not where I work, it's where I went for tx. It's a large hosp in Maine and we are pretty up on things. But I was SHOCKED! I told her where my best IV vein was (ignored) I told her I had no prob with a regular stick -- ignored. You know how we will aspirate back on an IV to see if there is a good blood return. There was none and there was none and there was none! But they kept trying and trying and trying and trying -- insisting that was how they had to draw the blood -- maddening. I wanted to grab the equip and do it myself. Sigh.
  5. by   ernurse728
    zoeboboey & newfloridaRN - why are you surprised about having lab work drawn from a newly inserted IV cathether? We draw blood and insert IV's into patients at once all the time. The lab draws are perfectly fine and you save the patient from more sticks? Am I missing something?
  6. by   newfloridaRN
    Thats exactly what I was asking!!!!!!
  7. by   Liddle Noodnik
    Originally posted by newfloridaRN
    Thats exactly what I was asking!!!!!!
    I'm sorry guys, I was misunderstanding. You say it happens a lot? Well, I suspose if you first put it in and you get a good blood return but after putting it in and capping it and waiting 45 min and then trying and not getting it for half an hour, to keep pulling and pulling?

    Weirdos, LOL!
  8. by   ernurse728
    We also draw blood from locks all the time....but I do say that if I try to pull from a lock and I don't get anything immediately than I stop and do a straight stick on the patient. If you don't get blood from a lock after you have attempted to aspirate and flushed the line you can pull until your fingers turn blue and you aren't going to get any blood...in that case all you are going to do is ruin your line.
  9. by   Liddle Noodnik
    Originally posted by ernurse728
    all you are going to do is ruin your line.
    That's why I thought people WOULDN'T use the lock, only as a last resort.

    I think what they did do was suck all the blood out of my surrounding capillaries. That sucker hurt for a WEEK!
  10. by   nightangel99
    I have drawn from IV locks several times with success. Usually what I do is flush with about 1 cc NS first, then aspirate. If that doesn't work, I leave well enough alone. If I have a patient that I know I will probably need to do more labs on later, I place an 18g IV in the patient. THey usually draw like dreams.

    One of the treatments I received in my ED was what we call the "Baker Cocktail" --named for one of our ER docs. It is strong, but effective: Benadryl 50 mg, Toradol 30 mg, Phenergan 25 mg, and MSO4 2 mg. That along with O2 at 2L per NC and 1 L NS. I ended up with a diagnosis after CT of Sinusitis. The CT showed fluid in my sphenoid sinus.

    Another thing - we do not have Compazine on our formulary anymore. Too many dystonic reactions were occuring as a result of giving it IV. The reactions are usually calmed by Benadryl, but we stopped using it nevertheless.
  11. by   Irwin0111
    patients suffering of migrane headache who come to seek medical magement. first, we give 1 sachet of novaluzid and then we give, mefenamic acid 500 mg capsule for pain, 1 serc tablet for dizziness, and 1 ampuole IM injection of tramadol and also 1 I.M. injection of plasil whether or not there is a feeling of nasea or episode of vomiting. the reason there is, is to avoid its occurrence. we usually avoid giving nalbuphine because it usually result to nausea and vomiting.
    these has proved to be effective at managing migraine headache especially when they come in during time where e.r. is busiest.
    kiwit
  12. by   uk_nurse
    I am a migraine sufferer, and get really bad ones. I get aura, vomiting and on occasions have had tingling in my hands and feet. I have never been to Accident and Emergency dept with my migraines. I am prescribed imigran by my G.P, which doesnt help much. Any advice on what i can take would be soooooo appreciated
  13. by   mackrn
    We treat staff with migraines in the Hyperbaric Chamber with great results. Unfortunately due to insurance not covering the cost we are not treating patients in the chamber for migraines at this time.

close