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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One hundred eight out of 256 (42%) surveys were completed by registered school nurses (SNs) working in the Connecticut public school system. Of the 108 respondents, 99% were RNs and 1% were LPNs. Each SN spent an average of 19 working days a month at school, in elementary (71%) and/or preschool (40%) settings. Professional experience and educational backgrounds were variable. Over 40% had never received formal instruction regarding childhood headache (CH), and an additional 32% had received less than two hours. School nurses ranked CH behind minor trauma, GI upset, and URI as the fourth of the 13 most common clinical problems encountered at school. An average of 35 children with headaches were seen each month. A brief description of, and inquiry about, other systemic symptoms were nearly always made. Only 62% of the SNs usually asked a child about neurological symptoms. A child's temperature and pulse were measured routinely by 84% of SNs, whereas blood pressure and neurological assessment were obtained routinely only in approximately 12%. Treatment varied; nonetheless, 31% routinely allowed the child to rest or sleep as part of their management plan. Analgesic was administered routinely only by 10%. Approximately one third generally discussed a disposition plan with the child's parents, whereas only 3% usually spoke with the child's physician. Although 51% of the respondents felt they were "constrained by school policy" in their management of CH, half of these individuals (71% of all respondents) did not want more latitude. It is concluded from this survey that despite limited formal instruction about CH, SNs dealt with CH in a reasonable manner.
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PMID:Childhood headaches: a school nurse perspective. 158 93

Headache remains a frequently encountered neurological symptom in Emergency department. Secondary causes of headache outnumber the primary entities such as migraine. Most of the secondary headaches have benign etiologies. The goal of emergent evaluation is to detect those with serious or life threatening causes. Identifying the pattern of headache helps in narrowing down the possible etiological diagnosis. A single episode of acute headache usually results from an acute infection ranging from viral URI to acute meningitis. Acute recurrent headaches are typically a feature of migraine. Chronic progressive headaches often indicate a serious underlying pathology such as a brain tumor and warrant a detailed neurological examination for signs of raised intracranial pressure (ICP) and focal deficits. Children with abnormal neurological findings require a neuroimaging. CT scan usually detects most of the abnormalities. Initial stabilization and management of raised ICP takes precedence in sick children. While simple analgesics like paracetamol and ibuprofen are used for symptomatic therapy, identification and appropriate treatment of underlying conditions is necessary for complete resolution of headache.
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PMID:Approach to headache in emergency department. 2201 37