2026-04-17T21:32:35Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/123912025-10-24T08:56:55Zcom_2072_378070com_2072_378040com_2072_378071col_2072_378092col_2072_378097

“Code Headache”: Development of a protocol for optimizing headache management in the emergency room Membrilla, Javier A. García-Yu, Raúl Mariño, Eduardo Díaz de Terán, Javier Alpuente Ruiz, Alicia Gómez Dabó, Laura Pozo-Rosich, Patricia Institut Català de la Salut [Membrilla JA] Department of Neurology, Hospital Universitari Francesc de Borja, Gandía, Spain. [Alpuente A, Pozo-Rosich P] Servei de Neurologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Grup de Recerca de Cefalea i Dolor Neurològic, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain. Unitat de Cefalees, Servei de Neurologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Gómez-Dabo L] Servei de Neurologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [García-Yu R, Mariño E] Department of Neurology, Hospital Universitario La Paz, Madrid, Spain. [Díaz-de-Terán J] Department of Neurology, Hospital Universitario La Paz, Madrid, Spain. Hospital La Paz Institute for Health Research - IdiPAZ (La Paz University Hospital, Universidad Autónoma de Madrid - Getafe Universitary Hospital - Universidad Europea de Madrid), Madrid, Spain Vall d'Hebron Barcelona Hospital Campus Cefalàlgia - Tractament Cefalàlgia - Diagnòstic Hospitals - Serveis d'urgències Dolor - Tractament ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Pain Management DISEASES::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Neurologic Manifestations::Pain::Headache Other subheadings::Other subheadings::/therapy HEALTH CARE::Health Care Facilities, Manpower, and Services::Health Facilities::Health Facility Administration::Hospital Administration::Hospital Departments::Emergency Service, Hospital TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::tratamiento del dolor ENFERMEDADES::afecciones patológicas, signos y síntomas::signos y síntomas::manifestaciones neurológicas::dolor::cefalea Otros calificadores::Otros calificadores::/terapia ATENCIÓN DE SALUD::instalaciones, servicios y personal de asistencia sanitaria::centros sanitarios::administración de establecimientos sanitarios::administración hospitalaria::departamentos hospitalarios::servicio hospitalario de urgencias Emergency department; Headache Servicio de urgencias; Cefalea Servei d'urgències; Cefalea Background and Purpose Patients presenting at the emergency room (ER) with headache often encounter a hostile atmosphere and experience delays in diagnosis and treatment. The aim of this study was to design a protocol for the ER with the goal of optimizing the care of patients with urgent headache to facilitate diagnosis and expedite treatment. Methods A narrative literature review was conducted via a MEDLINE search in October 2021. The “Code Headache” protocol was then developed considering the available characteristics and resources of the ER at a tertiary care center within the Spanish National Public Health system. Results The Code Headache protocol comprises three assessments: two scales and one checklist. The assessments identify known red flags and stratify patients based on suspected primary/secondary headaches and the need for pain treatment. Initial assessments, performed by the triage nurse, aim to first exclude potentially high morbidity and mortality etiologies (HEAD1 scale) and then expedite appropriate pain management (HEAD2 scale) based on scoring criteria. HEAD1 evaluates vital signs and symptoms of secondary serious headache disorders that can most benefit from earlier identification and treatment, while HEAD2 assesses symptoms indicative of status migrainosus, pain intensity, and vital signs. Subsequently, ER physicians employ a third assessment that reviews red flags for secondary headaches (grouped under the acronym ‘PEACE’) to guide the selection of complementary tests and aid diagnosis. Conclusions The Code Headache protocol is a much needed tool to facilitate quick clinical assessment and improve patient care in the ER. Further validation through comparison with standard clinical practice is warranted. 2025-01-09T12:39:47Z 2025-01-09T12:39:47Z 2024-12 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Membrilla JA, Alpuente A, Gómez-Dabo L, García-Yu R, Mariño E, Díaz-de-Terán J, et al. “Code Headache”: Development of a protocol for optimizing headache management in the emergency room. Eur J Neurol. 2024 Dec;31(12):e16484. 1468-1331 https://hdl.handle.net/11351/12391 10.1111/ene.16484 39287050 001314318300001 http://hdl.handle.net/11351/12391 eng European Journal of Neurology;31(12) https://doi.org/10.1111/ene.16484 Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess application/pdf Wiley Scientia