Headache History-Taking in an Emergency Department: Impact Evaluation of a Training Session

Abstract

Introduction: Headache represents about 25% of the total neurological consultations at the emergency department (ED). Up to 80% of these consultations are represented by primary headaches, in which an accurate and directed history-taking may help reach the specific diagnosis avoiding unnecessary complementary tests and reducing diagnostic latencies.

Methods: We carried out a training session on headache management at the ED, focusing on history-taking and primary headaches' diagnoses and management. We retrospectively compared the number of variables included in the medical reports and the percentage of patients who were diagnosed and/or treated for a primary headache between two months before and two months after the training session.

Results: A total of 369 medical histories were analyzed for this study (196 before and 173 after the training session). The number of essential variables regarding pain characteristics included in the medical reports showed a post-intervention increment from 4.34 ± 1.224 to 4.67 ± 1.079 (P = .007) and the number of total items registered also increased from 6.87 ± 1.982 to 7.53 ± 1.686 (P = 0.001). The percentage of patients that were given a specific diagnosis for primary headache showed an increment of 11.8% (P = .002) in the post-intervention group.

Conclusion: Educational interventions can improve history-taking in headache patients in the ED. This fact grants them as potential efficient measures to optimize patient management at Emergency Room.

Keywords: Emergency Department; History-Taking; Migraine; Neurology; Trainees; Training Session.