Tag: headache

Journal club: SAH and systematic reviews

Thanks to Dr Szechi Freidanck for her presentation.




Take home points:

  1. The quality of a systematic review is determined by the relative quality of the included and excluded studies. The AMSTAR tool is a way to assess the methodological rigor of the systematic review
  2. A Likelihood ratio of close to 1 means a test is not practically useful
  3. Aim to rapidly assess headaches to facilitate CT brain early where possible; but beware of diagnostic momentum – the history is king in cases of headache, and poor initial assessments can have downstream effects for the patient

Winter’s Wrap 30/11/16 – LPs, violence in ED, migraine

Summary of teaching wednesday 30/11/16 – dr karen winter (demt footscray)



Beware of the sitting duck for a vasovagal! consider balancing them against the side of the trolley to stabilise
Opening pressure must be measured in the lateral position – but only a few indications for measuring
Take your time setting up and insist on an assistant
Involve your patient – “drop your shoulders please”….”am I in the middle?”

Consider the timing of anticoagulation or antiplatelet agents –
Heparin 6 hours
Clexane 12 hours
INR < 1.3
Aspirin – OK
NOACs or Clopidgrel – NOT FOR YOU!!!
We were lucky to have a chance to practice on the LP models and have a look at US assisted LP.


Are we making this “normal” because it’s NOT!
Check the ALERTS – 3 locations on EDIS
Chart prn medications on arrival, not after the incident has occurred!
Behaviour Safety Support Plans – consider triggers and subtle signs of impending violence


Chlorpromazine (Largactil) needs to be at an appropriate rate
Chart regular analgesia
Consider sumatriptan on discharge in recurrent presenters