Format

Send to

Choose Destination
See comment in PubMed Commons below
J Pediatr. 2013 Dec;163(6):1634-7. doi: 10.1016/j.jpeds.2013.07.006. Epub 2013 Aug 20.

Diagnostic testing and treatment of pediatric headache in the emergency department.

Author information

  • 1Department of Pediatrics, Oregon Health and Science University, Portland, OR. Electronic address: sheridda@ohsu.edu.

Abstract

OBJECTIVE:

To describe the variability in diagnostic testing and treatment of headaches in children presenting to the emergency department (ED) with use of a nationally representative sample.

STUDY DESIGN:

This was a retrospective cohort study using the National Hospital Ambulatory Medical Care Survey during 2005-2009. To assess the use of evidence-based treatment, we analyzed all patients <18 years old in 2 groups: (1) primary discharge diagnosis of headache and (2) discharge diagnosis of migraine.

RESULTS:

Four hundred forty-eight sampled ED visits from 2005-2009 represented a national estimate of 1.7 million visits with a discharge diagnosis of headache. A total of 95 visits represented a national estimate of 340 000 visits with a discharge diagnosis of migraine. Median age was 13.1 years and 60% were female with a primary diagnosis of headache. In this group, neuroimaging was performed in 37% of patients and 39% underwent blood tests. Nonsteroidal anti-inflammatory drugs and opioids were most commonly used for treatment. For children with a discharge diagnosis of migraine, approximately 40% of patients received non-evidence-based treatment, most commonly with opioid medications, and >20% of patients underwent computed tomography scanning.

CONCLUSIONS:

There is significant variability in the evaluation and treatment of pediatric headache in the ED. Despite evidence-based clinical guidelines for migraine headache, a large number of children continue to receive opioids and ionizing radiation in the ED.

Copyright © 2013 Mosby, Inc. All rights reserved.

KEYWORDS:

CBC; CT; Complete blood cell count; Computed tomography; EBT; ED; Emergency department; Evidence-based treatment; NHAMCS; NSAID; National Hospital Ambulatory Medical Care Survey; Nonsteroidal anti-inflammatory drug

[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk