Volume 14, Issue 10: Migraine – what a headache!

Migraine – what a headache!

It’s November – grey, gloomy and damp, the second job of the shift comes in. It’s a call to a 52-year-old female with a “severe headache”. When you arrive you assess the patient and find that she has had migraines in the past, you decide to leave her at home with worsening advice for migraine. Later you start to worry –  did you miss some big red flags in her history?

CPD benefit

Migraines are extremely common, experienced by around 12% of people, paramedics will often encounter patients experiencing migraines on the more severe end of the spectrum. This article describes the pathophysiology and signs and symptoms of migraine, it also provides guidance on how to provisionally diagnose migraine which can be challenging in the pre-hospital setting. There is advice on assessment, treatment options and long-term management of the condition to help you effectively manage your patient by excluding red flags and concerns of a secondary headache disorder which might warrant transportation to an ED or onward referral.