Migrane Headache Treatment in the ED

athomas91 · Aug 22, 2003

one of the doc's i work w/ is an older doc - he uses 0.4mg haldol and it relieves both nasea and pain i- believe it or not - and he uses it SQ....

KaroSnowQueen, RN · Aug 22, 2003

I went in c/o of a screaming migraine that lasted four days at that point, getting to the point of nonfunctionalness (is that a word?). I had taken Ibuprofen, Tylenol, Excedrin, Benadryl, Lortab. Nothing worked.

They gave me Stadol and Phenergan, don't know how much, didn't CARE. Knocked me out with that on Friday afternoon, slept all night, most of the day Saturday and pretty dozy on Sunday. Monday my headache was gone.

BUT I think the key was that I too said I didn't CARE WHAT they gave me just as long as they made it QUIT !!!!

Rhoresmith · Aug 22, 2003

My 17 yo daughter has Chronic Migraines at one point 30-60 per month she was 12 and had a headache 24\7 for six months with no relief. She had MRI, Lumbar Puncture blood work and a Nuero doctor who started her out on such an ineffective dose of Elavil (sorry about spelling) that by the time she got to a dose that would work she would have been 20. Finally after going to a ST Louis Childrens hospital and having another Neurologist tell us she was spoiled and overweight and didn't want to go to school (she loved school always did) and being given Narcotics to take at home even had one pain management doc recomend giving her a small injection of Morphine everyday before school ( real smart huh!!! giving a 12 year old Morphine ) we were sent to Diamond Headache Clinic in Chicago Il. They have been wonderful it has taken about 40 different medications in some very strange combinations but she is down to 6-10 bad bad migraines a month and still has alot of daily chronic headaches but she is so TOUGH that these seem like a walk in the park to her. I feel the reason it took so long to get them under even this limited control is that her Thyroid was going out (hypothroidism) Diamond does major blood work and her TSH would be high then they would repeat and back to normal Then on a hospital visit it was 35 one day then 38 two days later and a goiter appeared she takes synthroid and now meds seem to be working better.

Also just wanted to make comment, my daughter never has had light sensitivty and very rarely throws up and NEVER has had an aura but she DOES have Migraines. I have never taken her to the ER without family doc calling and then he request she be treated and she has only had 7 shots of narcotics in 5 years and it is always dolaphine and only when she is in Hospital in Chicago and we knew a 15 yo girl who KILLED herself because of Migraines and the fact that she couldnt take the pain so until you have a Headache or watch someone you love suffer from one you should never judge and from being in hospital ward with30-45 people suffering from headaches many of these people do know exactly what works and many develope allergies because of such frequent use of meds for these chronic sufferers. Sorry so long this is a subject near and dear to my heart and I have heard the Migraine sufferers in the group sessions on the headache floor talk about being treated so badly in ER's and these people are in physical and mental agony and many have suffered for 20-30 years with this horrific disease and have even been put in mental wards

Rhonda

berry · Aug 22, 2003

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

Liddle Noodnik · Aug 22, 2003

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... :)

newfloridaRN · Aug 23, 2003

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?!?!

Liddle Noodnik · Aug 23, 2003

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.

ernurse728, LPN · Aug 23, 2003

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?

newfloridaRN · Aug 24, 2003

Thats exactly what I was asking!!!!!! :confused:

Liddle Noodnik · Aug 24, 2003

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!

ernurse728, LPN · Aug 24, 2003

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.

Liddle Noodnik · Aug 24, 2003

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!