Page 310 - 2021 IDMT Digital

CLUSTER HEADACHE
Introduction:
• %HQLJQ VHYHUH LQFDSDFLWDWLQJ KHDGDFKH WKDW RFFXUV LQ UHFXUULQJ SDWWHUQV
• 3DWLHQWV W\SLFDOO\ DUH YHU\ DJLWDWHG ZLWK EHKDYLRU VXFK DV SDFLQJ \HOOLQJ RU WKUDVKLQJ
Subjective:
• 6LJQV DQG 6\PSWRPV
o 3DLQ W\SLFDOO\ XQLODWHUDO LQ WHPSRUDO RUELWDO DUHD RFFXUULQJ DW WKH VDPH WLPH HDFK
GD\ RU LQ D SDWWHUQ RU JURXS ³FOXVWHUV´
o 3DLQ PD\ ZDNH SDWLHQW IURP VOHHS
o 3DLQ LV H[FUXFLDWLQJ EXW SHDNV ZLWKLQ PLQXWHV DQG XVXDOO\ UHVROYHV ZLWKLQ DQ KRXU
Objective:
• 3K\VLFDO ([DP
o 5HTXLUHV IXOO QHXURORJLFDO H[DP
o 0D\ KDYH QDVDO FRQJHVWLRQ UKLQRUUKHD ODFULPDWLRQ IDFLDO IOXVKLQJ DQG +RUQHU¶V
V\QGURPH SWRVLV PLRVLV HQRSKWKDOPRV DQG DQKLGURVLV RQ WKH LSVLODWHUDO VLGH
Assessment:
• 'LIIHUHQWLDO
o 7HQVLRQ KHDGDFKH SHULFUDQLDO WHQGHUQHVV ³EDQGOLNH´ WLJKW TXDOLW\ GDLO\
KHDGDFKHV ZRUVH ZLWK VWUHVV/IDWLJXH, PRVW LQWHQVH DW QHFN FDQ RYHUODS ZLWK
PLJUDLQH
o 0LJUDLQH KHDGDFKH SKRWRSKRELD SKRQRSKRELD QDXVHD YRPLWLQJ
o 3RVW FRQFXVVLYH IROORZV KHDG LQMXU\ UHIHU
o 0HQLQJLWLV IHYHU QHFN SDLQ DQG VWLIIQHVV
Plan:
• 6XEFXWDQHRXV or intranasal VXPDWULSWDQ
• R[\JHQ YLD QRQ UHEUHDWKHU PDVN DW L/min IRU -20 PLQXWHV
Patient Education:
• 5HGXFH VWUHVV UHJXODWH VOHHS F\FOH HDW UHJXODU PHDOV K\GUDWH
• $YRLG WULJJHUV LI SRVVLEOH
• 'DLO\ SUHYHQWDWLYH PHGLFDWLRQ LV LQGLFDWHG LI KHDGDFKHV DUH IUHTXHQW RU FDXVH VHYHUH
GLVDELOLW\
• 1HZ RQVHW RI KHDGDFKH RU FKDQJH LQ KHDGDFKH UHTXLUHV ZRUN XS (9$& WUDQVIHU
• )ROORZ XS $FWLRQV
o 5HWXUQ LI V\PSWRPV GR QRW LPSURYH ZLWKin KRXUV
o ,I KHDGDFKH UHPDLQV XQFRQWUROOHG RU LQFUHDVHV LQ VHYHULW\ FRQVLGHU
(9$& WUDQVIHU
o (9$& WUDQVIHU IRU ³UHG IODJ´ V\PSWRPV
Preceptor Directive:
• Blue Directive: Contact Preceptor Immediately

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