i am wondering how are headaches/migraines treated in your ers?
in our er docs mostly give narcotics and antiemetics. as an ex-neuro nurse i was very surprised by that, because our neurologists absolutely will not give narcs because it causes rebound headaches. upstairs we did mostly dhe protocol, caffeine, depakote, reglan loading protocol if all of the above didn't work, quiet room, icepacks, darkness, hydration and oxygen,etc.
the er docs explained to me that "we don't have time to do all that, we want to stop the pain and get the person home" (with a lortab prescription usually). none the less, the patients stay at least 4 hours even if they get narcotics, then they come back 2 days later because the pain is back and the neurologist can not see them this week.
Here is a great old fashioned "cure they pts can do all by their little lonesomes! My son at age six used to take his little ring fingers fourth from his thumbs) place them on either side of my a person's temple(forehead ) and gently rub tell them close your eyes, imagine a peaceful place.
I do that all the time...doesn't work for status migraine. Status migraine is much much different than stress or tension headache, and much more complex
Specializes in ER,Neurology, Endocrinology, Pulmonology.
here is a great old fashioned "cure they pts can do all by their little lonesomes! my son at age six used to take his little ring fingers ...............all for that matter!
02-01-2008 04:11 pm >>>> posted by lisencedand certified.
IV, WO fluids, Benadryl, Compazine, cool dark room with the lights off. Rinse and repeat if necessary.
This works probably 99.9% of the time. DHE has become popular lately too. Occassionally I see them order Nubain or Toradol for the most stubborn BUT they exhaust other avenues 1st including a head CT.
For those with a list of allergies a mile long or for the 0.1% where the above doesn't work - they get shipped to our big "sister" facility for a neuro consult.
Patient Care Technology thank you, its too new for most places, some hospital staff think PCT 's are C N A's, wrong.I had to take exams to get a license,some PCT's are taught to do everything LPN's and RN's can do. Clinicals were at a hospital on a telemetry unit for 300 hours, with 300 hours in palliative care in Hospice.I worked as soon as I graduated since I acquired my PCT license as soon as I could, was told I was hired because of my PCT license, and from a great school that has as a teacher an RN for 18 years who made sure her students knew their business and ethics.Maybe those in question are not licensed to pass out medicines, maybe they are PCT's or worse, but the only difference between a NCPCT( Nationally Certified PCT with a license) with 25 years of experience (and legally certified to pass hospice meds under pt and doctors orders) and a LPN or even RN is :a PCT is not allowed to pass out meds, and can perform nursing routines like IV's, catheters only if it is legally in that agency's policies etc. is which I hope the above people who are giving out medicines that are addictive and dangerous and illegal remeber. Believe me I have been in the business of caring for the dying for over 25 years, and will continue for 50 more and not settle for ancient remedies like poor unethical wokers passing out illegal dangerous substances. I was not hired to keep my mouth shut, in fact my workplace has a zero tolerance for substance abuse and illegal use of prescribed drugs. What do you do? Do you have a job? I have had mine a long long time and get paid very well thank you please. I and my colleagues have only five pts at the most in a setting of only 70 pts at full house... a dream job compared to others. To get a PCT license, one needs to have a CNA License, it used to be called a certification, this year its changed, as did the CPR manuevers, ie 15 compared to 30 compressions etc. We answer to the pts first, with their doctors and nurses care plans followed , not according to our own preferences and such...
Wow very interesting. Our hospital uses PCT's but none of them have any type of certification (much less a license) except their CNA. What body issues the licenses? Sorry just had never heard of this.
Wow very interesting. Our hospital uses PCT's but none of them have any type of certification (much less a license) except their CNA. What body issues the licenses? Sorry just had never heard of this.
The most effective way i've seen a headache treated was reglan 10mg ivp, benadryl 25mg ivp, and 1 liter .9ns wide open. I'd say within 10 minutes just about all of my patients with headaches were thanking me because their pain was relieved.
I just had a killer migraine that blew in the thunderstorms for Valentine's day... I even had Valentine's day off. I threw up x4 at work, came home, took my rescue meds, crashed...woke up 23 hours later. I was supposed to go out for dinner with DH...oh well...talk about sleeping it off.
Here is a great old fashioned "cure they pts can do all by their little lonesomes! My son at age six used to take his little ring fingers fourth from his thumbs) place them on either side of my a person's temple(forehead ) and gently rub tell them close your eyes, imagine a peaceful place.
Works wonders for me when I used to get headaches, funny thing is, now I have not ever got one since he "cured " mine.. "breathe deeply mama, in thru nose, out thru your mouth". Need I say he is a Doctor now, after years of being a boy who just loved his dogs, cats and being our youngest , wildest son in our family. No, I do not have to brag, he was raised to know the miraculous power of the healing that comes thru faith, education, simple wholesome living, lots of exercise and pure simple love. He claimed a Shaman taught him to do such a work, so who was I to question eternal powers? What else did he learn 18 years ago, in a Christian commune living with his father and brother until I could sweet talk his father away from what our family considered a dangerous cult situation,:w00t::pumpiron: I was all alone in taking my two beloved sons and their father away from the cult in my own car to get them to safety. But looking back, if my sons learned from "health fanatics,vegetarians, and wayward Indians (Shamans) while they lived with their father estranged from me, well all I can do now is laugh at myself for being a worried concerned parent had an open minded bunch of individuals surrounding them, so I gave up and allowed him to keep the kids,(single moms and my family do not survive very long without criticism, contempt etc.) My sons deserved better than for me to deprive them of their father, he cared even if he was a little strange, he was a Great White Father ... with many many dreams and visions. LOL I laugh a lot now knowing he and I were stupid young foolish parents and its a miracle our sons survived as poor as he raised them, dirt poor, and he an Educated ship fitter, welder, Aeronautic mechanic. My sons grew up in his "care" without a complaint from me registered in California's court of laws because I knew better than to throw myself upon the mercy of the courts. I am a licensed professional, and know the difference between right and wrong. It is wrong to deprive children of either parents love and affection and attention, and lets carry that over into the "Caring workplace, Nursing homes, hospitals etc and see how far we all can run with a noble new way of doing things no matter how long we have been "At this" profession called nursing. Is it not unethical to give out medication for headaches that are highly narcotic and addictive? Wrongdoing is wrongdoing no matter where its done, how its done, who does it etc!!
I use his "cure" sometimes, in my work I take time to give our pts backrubs, so this comes naturally. I work at a very caring loving environment, in palliative caring for the dying. Too bad TLC can not be incorporated diligently into more health care environments, after all, what is a therapeutic environment if not a place of genuine care and health needs being met of ones clients? No Time baloney... I was taught to MANAGE precious time so well that I can do above and beyond for others in our care, or else I went to a totally different type of educational center too far ahead of its time than most in my field really need to publish a ton of books on all the treatments my sons remembered to tell me when I last saw them , after recording everything I could, I wrote extensive private journals to refer to and document other goings on many many things were questionable at that ancient time, the 80's, so now I have tons of paperwork to attend , my own fault of course, but is it's ones own fault if one is to dare venture out and make mistakes once in a while?Now please lets not get me started on frivolous lawsuits. or any lawsuit at all for that matter!:cheers:
I'm having a horribly hard time following your posts....
Patient Care Technology thank you, its too new for most places, some hospital staff think PCT 's are C N A's, wrong.I had to take exams to get a license,some PCT's are taught to do everything LPN's and RN's can do. Clinicals were at a hospital on a telemetry unit for 300 hours, with 300 hours in palliative care in Hospice.I worked as soon as I graduated since I acquired my PCT license as soon as I could, was told I was hired because of my PCT license, and from a great school that has as a teacher an RN for 18 years who made sure her students knew their business and ethics.Maybe those in question are not licensed to pass out medicines, maybe they are PCT's or worse, but the only difference between a NCPCT( Nationally Certified PCT with a license) with 25 years of experience (and legally certified to pass hospice meds under pt and doctors orders) and a LPN or even RN is :a PCT is not allowed to pass out meds, and can perform nursing routines like IV's, catheters only if it is legally in that agency's policies etc. is which I hope the above people who are giving out medicines that are addictive and dangerous and illegal remeber. Believe me I have been in the business of caring for the dying for over 25 years, and will continue for 50 more and not settle for ancient remedies like poor unethical wokers passing out illegal dangerous substances. I was not hired to keep my mouth shut, in fact my workplace has a zero tolerance for substance abuse and illegal use of prescribed drugs. What do you do? Do you have a job? I have had mine a long long time and get paid very well thank you please. I and my colleagues have only five pts at the most in a setting of only 70 pts at full house... a dream job compared to others. To get a PCT license, one needs to have a CNA License, it used to be called a certification, this year its changed, as did the CPR manuevers, ie 15 compared to 30 compressions etc. We answer to the pts first, with their doctors and nurses care plans followed , not according to our own preferences and such...
huh?
So you are a patient care tech... a nursing assistant, right?
I'm having a horribly hard time following your posts....
I agree with beachbum, What ? What is your point? What state are you in? Never heard of this lic. Our docs use reglan, benadryl and IVF-- it works every time.
? What is your point? What state are you in? Never heard of this lic. Our docs use reglan, benadryl and IVF-- it works every time.
LeesieBug
717 Posts
toradol, compazine, benadryl....this trio is the most popular in our ER, and tends to be effective for most patients.
We have a couple docs that will throw in some nubain.
One doc is a fan of caffiene......
One doctor loves droperidol.
Another prefers DHE
funny...you can pretty much tell who wrote the order just by the med combinations.