TY - JOUR
T1 - Clinical Policy
T2 - Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Headache: Approved by the ACEP Board of Directors June 26, 2019 Clinical Policy Endorsed by the Emergency Nurses Association (July 31, 2019)
AU - American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Acute Headache:
AU - Wolf, Stephen J.
AU - Byyny, Richard
AU - Carpenter, Christopher R.
AU - Diercks, Deborah B.
AU - Gemme, Seth R.
AU - Gerardo, Charles J.
AU - Godwin, Steven A.
AU - Hahn, Sigrid A.
AU - Harrison, Nicholas E.
AU - Hatten, Benjamin W.
AU - Haukoos, Jason S.
AU - Kaji, Amy
AU - Kwok, Heemun
AU - Lo, Bruce M.
AU - Mace, Sharon E.
AU - Nazarian, Devorah J.
AU - Proehl, Jean
AU - Promes, Susan B.
AU - Shah, Kaushal H.
AU - Shih, Richard D.
AU - Silvers, Scott M.
AU - Smith, Michael D.
AU - Thiessen, Molly E.W.
AU - Tomaszewski, Christian A.
AU - Valente, Jonathan H.
AU - Wall, Stephen P.
AU - Cantrill, Stephen V.
AU - Hirshon, Jon M.
AU - Schulz, Travis
AU - Whitson, Rhonda R.
AU - Cherkas, David S.
AU - Panagos, Peter D.
N1 - Publisher Copyright:
© 2019 American College of Emergency Physicians
PY - 2019/10
Y1 - 2019/10
N2 - This clinical policy from the American College of Emergency Physicians addressed key issues in the evaluation and management of adult patients presenting to the emergency department with acute headache. A writing subcommittee conducted a systematic review of the literature to derive evidence-based recommendations to answer the following clinical questions: (1) In the adult emergency department patient presenting with acute headache, are there risk-stratification strategies that reliably identify the need for emergent neuroimaging? (2) In the adult emergency department patient treated for acute primary headache, are nonopioids preferred to opioid medications? (3) In the adult emergency department patient presenting with acute headache, does a normal noncontrast head computed tomography scan performed within 6 hours of headache onset preclude the need for further diagnostic workup for subarachnoid hemorrhage? (4) In the adult emergency department patient who is still considered to be at risk for subarachnoid hemorrhage after a negative noncontrast head computed tomography, is computed tomography angiography of the head as effective as lumbar puncture to safely rule out subarachnoid hemorrhage? Evidence was graded and recommendations were made based on the strength of the available data.
AB - This clinical policy from the American College of Emergency Physicians addressed key issues in the evaluation and management of adult patients presenting to the emergency department with acute headache. A writing subcommittee conducted a systematic review of the literature to derive evidence-based recommendations to answer the following clinical questions: (1) In the adult emergency department patient presenting with acute headache, are there risk-stratification strategies that reliably identify the need for emergent neuroimaging? (2) In the adult emergency department patient treated for acute primary headache, are nonopioids preferred to opioid medications? (3) In the adult emergency department patient presenting with acute headache, does a normal noncontrast head computed tomography scan performed within 6 hours of headache onset preclude the need for further diagnostic workup for subarachnoid hemorrhage? (4) In the adult emergency department patient who is still considered to be at risk for subarachnoid hemorrhage after a negative noncontrast head computed tomography, is computed tomography angiography of the head as effective as lumbar puncture to safely rule out subarachnoid hemorrhage? Evidence was graded and recommendations were made based on the strength of the available data.
UR - http://www.scopus.com/inward/record.url?scp=85072535102&partnerID=8YFLogxK
U2 - 10.1016/j.annemergmed.2019.07.009
DO - 10.1016/j.annemergmed.2019.07.009
M3 - Review article
C2 - 31543134
AN - SCOPUS:85072535102
SN - 0196-0644
VL - 74
SP - e41-e74
JO - Annals of Emergency Medicine
JF - Annals of Emergency Medicine
IS - 4
ER -