Migrane Headache Treatment in the ED

nightangel99 · Aug 31, 2003

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.

Irwin0111 · Sep 17, 2003

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

uk_nurse · Sep 17, 2003

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

mackrn · Sep 19, 2003

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.

Liddle Noodnik · Sep 19, 2003

Originally posted by mackrn
We treat staff with migraines in the Hyperbaric Chamber with great results. .

Mack, why does that work?

I am so mad, I had found the PERFECT doc to help with my new dx of migraines, she actually wanted to do more than write a prescription, and she left the state.

teeituptom, BSN, RN · Sep 19, 2003

Hi yall

When the ER is hopping and patients are backed up is when you get most of your Migrainers in. Now I feel the best you can do for them is ask them what works best, Give it to them and send them home with someone to drive for them. Take the path of leastresistance, saves you a headache yourself.

mackrn · Sep 19, 2003

One of the reasons there is pain with migraines due to the vasospasms causing some anoxia to the area. Also is effective in treating hangovers for the same reason

Liddle Noodnik · Sep 20, 2003

Originally posted by mackrn
One of the reasons there is pain with migraines due to the vasospasms causing some anoxia to the area. Also is effective in treating hangovers for the same reason

Cool! Makes sense to me, Thanks Mack!

Iam46yearsold · Oct 29, 2008

I like to give them what works best and send them on their way. Life is easier

Irwin0111 · Oct 30, 2008

One of the reasons there is pain with migraines due to the vasospasms causing some anoxia to the area. Also is effective in treating hangovers for the same reason

maybe you mean due to vasodilation caused by anoxia, Decreased O2 and Increased CO2 levels dilate vessels in the brain, until the ache is like exploding. and it makes more sense to treat the patient into a hyperbaric chamber. :bow:

Iam46yearsold · Nov 2, 2008

Most patients prefer a Dilaudid chamber