Headache (Non-Traumatic) BLS PCS Standard

What potential life/limb/function threats should be considered when treating a patient with a non-traumatic headache?

• intracranial/intracerebral events

  • hemorrhage

  • thrombosis

  • tumour

• central nervous system infection

• systemic infection

• severe hypertension

• toxic event/exposure incident (e.g., carbon monoxide poisoning)

What signs/symptoms can indicate a serious underlying cause/disorder for a non-traumatic headache?

• sudden onset of severe headache with no previous medical history of headache

• recent onset headache (days, weeks) with sudden worsening

• change in pattern of usual headaches

• altered mental status

• decrease in level of consciousness

• neurological deficits

• obvious nuchal rigidity, fever, other signs of infection

• pupillary abnormalities

• visual disturbances

What are the critical assessments required at minimum during a secondary survey of a patient with a non-traumatic headache?

central nervous system for:

• abnormal motor function

  • loss of hand grip strength

  • abnormal arm/leg movement

  • arm/leg drift

• sensory loss

head/neck for:

• pupillary size

• pupil equality

• pupil reactivity

What are other potential complications/problems of a patient with a non-traumatic headache that a paramedic should consider and prepare for?

• seizures

• hypertensive crisis

• transient ischemic attack

• sickle cell crisis

• hepatic encephalopathy

• glaucoma

• peripheral vertigo

• sinusitis