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[Headache in a pediatric emergency department]
A Palmieri1, S Mangini, P Salvati
1U.O. di Pronto Soccorso Medico e Medicina d'Urgenza, Istituto Giannina Gaslini, Genova. antonellapalmieri@ospedale-gaslini.ge.it
Insights
Pediatric emergency department visits for headache are rising, impacting child and family quality of life. Improved family education and coordinated care are essential for managing pediatric headaches.
Area of Science:
- Pediatric Emergency Medicine
- Neurology
- Public Health
Context:
- Headache is a prevalent pediatric symptom significantly impacting quality of life.
- Pediatric Emergency Departments (PEDs) frequently manage headache admissions.
- Primary headaches, like migraine without aura, are common; secondary headaches, often infection-related, constitute a significant portion of acute onset cases.
Purpose:
- To analyze pediatric headache admissions at a Pediatric Emergency Department.
- To evaluate the clinical and diagnostic pathways for pediatric headache patients.
- To identify trends and inform management strategies for pediatric headaches.
Summary:
- A 7-year study (2000-2006) at the G. Gaslini Institute PED analyzed 2,214 headache admissions (55% male).
- Triage categories included white (14.3%), green (74.3%), yellow (10.8%), and red (0.6%) codes.
- Outcomes comprised hospitalization (38%), other basic interventions (OBI) (8%), and home/ambulatory care (54%).
Impact:
- Findings indicate an increasing trend in pediatric headache ED visits.
- Highlights the need for enhanced family education regarding pediatric headaches.
- Emphasizes the necessity for better coordination between community healthcare services and hospital-based clinic management.
Introduction:
Headache, a very frequent symptom in pediatrics, can severely affect the child and his family's life quality, representing an important reason of access to a Pediatric Emergency Department. From a clinical point of view, it is useful to subdivide headaches in primary and secondary ones. As far as the primary ones are concerned, the common migraine without aura is recognised as the most frequent in the child, while the most recurrent among the second ones are due to infective processes, and they represent 57% of the patients admitted to ED for headache with acute onset.
Materials And Methods:
We analyzed data collected from June 2000 to December 2006, at the Pediatric Emergency Department of Institute "G. Gaslini" Genoa, concerning the admissions of patients with headache, with particular attention to the necessity of coming up with a clinical and diagnostical path.
Results:
During the study, there have been 228.255 admissions, 2.214 of which with a diagnosis of discharge from ED of headache (55% males, 45% females). After triage, 14,3% has been evaluated as white code, 74,3% as green one, 10,8% as yellow one and 0,6% as red code. Final outcome of these patients has been hospitalization for 38%, OBI for 8%, home or ambulatory control for 54%.
Conclusions:
The accesses to ED for headache are increasing. Better information of the family is needed, with coordination among territorial structures and clinic management in ED.
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