26. Emergency Medical Services Transport of Patients Complaining of Headache: Does Mode of Arrival Suggest Serious Etiology?

Extract

Purpose: Headache is a very common complaint in emergency medicine. Its causes are myriad, ranging from benign to life-threatening. Patients who access emergency medical services (EMS), often do so after self-assessment has indicated high acuity. We conducted this study to determine if patients transported by EMS with a chief complaint of headache have a higher rate of serious etiology.

Methods: This observational, retrospective study, was conducted by consecutive review of charts on all patients presenting to the emergency department (ED) from December 1994 through May 1995 with a chief complaint of headache. Patients presenting with other manifestations of intracranial pathology (ICP), such as altered mental status or seizures, were excluded. Mode of arrival was determined to be either via emergency medical services (EMS) or other means. Patients were categorized as having serious (meningitis, hemorrhage, tumor) or benign (migraine, etc.) ICP, based final diagnosis. It was noted whether or not diagnostic studies (DS), such as CT scan and lumbar puncture, were performed. Statistical analysis was performed using the Yates corrected chi-square test.