Inadequacy of Headache Management After Subarachnoid Hemorrhage
2016; American Association of Critical-Care Nurses; Volume: 25; Issue: 2 Linguagem: Inglês
10.4037/ajcc2016486
ISSN1937-710X
AutoresElizabeth Glisic, L. Gardiner, L. Josti, Elizabeth Dermanelian, Sandra Ridel, John Dziodzio, Barbara McCrum, Ben Enos, Patricia Lerwick, Gilles L. Fraser, P. Muscat, Richard R. Riker, Robert D. Ecker, Jeffrey E. Florman, David B. Seder,
Tópico(s)Neurosurgical Procedures and Complications
ResumoCritical Care Evaluation| March 01 2016 Inadequacy of Headache Management After Subarachnoid Hemorrhage Elizabeth K. Glisic, PharmD; Elizabeth K. Glisic, PharmD Elizabeth K. Glisic and Gilles L. Fraser are clinical pharmacists in critical care and Ben Enos is a clinical pharmacist, Department of Pharmacy, Maine Medical Center, Portland, Maine. Linda Gardiner, Linda Josti, Elizabeth Dermanelian, and Sandra Ridel are neurocritical care nurses, Department of Nursing, Maine Medical Center. Barbara McCrum is a clinical research nurse coordinator, Neuroscience Institute, Maine Medical Center. John Dziodzio is a programmer/analyst and Patricia Lerwick is an intensivist physician, Department of Critical Care Services, Maine Medical Center. Paul Muscat is chief of neurology, Department of Medicine, Maine Medical Center. Robert Ecker and Jeffrey Florman are attending neurosurgeons, Neuroscience Institute, Maine Medical Center. Richard R. Riker is director of medical intensive care and David B. Seder is director of neurocritical care, Department of Critical Care Services, Maine Medical Center. Corresponding author: Elizabeth K. Glisic, pharmd, Department of Pharmacy, 22 Bramhall St, Portland, ME 04102 (e-mail: glisie@mmc.org). Search for other works by this author on: This Site PubMed Google Scholar Linda Gardiner, RN; Linda Gardiner, RN Elizabeth K. Glisic and Gilles L. Fraser are clinical pharmacists in critical care and Ben Enos is a clinical pharmacist, Department of Pharmacy, Maine Medical Center, Portland, Maine. Linda Gardiner, Linda Josti, Elizabeth Dermanelian, and Sandra Ridel are neurocritical care nurses, Department of Nursing, Maine Medical Center. Barbara McCrum is a clinical research nurse coordinator, Neuroscience Institute, Maine Medical Center. John Dziodzio is a programmer/analyst and Patricia Lerwick is an intensivist physician, Department of Critical Care Services, Maine Medical Center. Paul Muscat is chief of neurology, Department of Medicine, Maine Medical Center. Robert Ecker and Jeffrey Florman are attending neurosurgeons, Neuroscience Institute, Maine Medical Center. Richard R. Riker is director of medical intensive care and David B. Seder is director of neurocritical care, Department of Critical Care Services, Maine Medical Center. Search for other works by this author on: This Site PubMed Google Scholar Linda Josti, RN; Linda Josti, RN Elizabeth K. Glisic and Gilles L. Fraser are clinical pharmacists in critical care and Ben Enos is a clinical pharmacist, Department of Pharmacy, Maine Medical Center, Portland, Maine. Linda Gardiner, Linda Josti, Elizabeth Dermanelian, and Sandra Ridel are neurocritical care nurses, Department of Nursing, Maine Medical Center. Barbara McCrum is a clinical research nurse coordinator, Neuroscience Institute, Maine Medical Center. John Dziodzio is a programmer/analyst and Patricia Lerwick is an intensivist physician, Department of Critical Care Services, Maine Medical Center. Paul Muscat is chief of neurology, Department of Medicine, Maine Medical Center. Robert Ecker and Jeffrey Florman are attending neurosurgeons, Neuroscience Institute, Maine Medical Center. Richard R. Riker is director of medical intensive care and David B. Seder is director of neurocritical care, Department of Critical Care Services, Maine Medical Center. Search for other works by this author on: This Site PubMed Google Scholar Elizabeth Dermanelian, RN; Elizabeth Dermanelian, RN Elizabeth K. Glisic and Gilles L. Fraser are clinical pharmacists in critical care and Ben Enos is a clinical pharmacist, Department of Pharmacy, Maine Medical Center, Portland, Maine. Linda Gardiner, Linda Josti, Elizabeth Dermanelian, and Sandra Ridel are neurocritical care nurses, Department of Nursing, Maine Medical Center. Barbara McCrum is a clinical research nurse coordinator, Neuroscience Institute, Maine Medical Center. John Dziodzio is a programmer/analyst and Patricia Lerwick is an intensivist physician, Department of Critical Care Services, Maine Medical Center. Paul Muscat is chief of neurology, Department of Medicine, Maine Medical Center. Robert Ecker and Jeffrey Florman are attending neurosurgeons, Neuroscience Institute, Maine Medical Center. Richard R. Riker is director of medical intensive care and David B. Seder is director of neurocritical care, Department of Critical Care Services, Maine Medical Center. Search for other works by this author on: This Site PubMed Google Scholar Sandra Ridel, RN; Sandra Ridel, RN Elizabeth K. Glisic and Gilles L. Fraser are clinical pharmacists in critical care and Ben Enos is a clinical pharmacist, Department of Pharmacy, Maine Medical Center, Portland, Maine. Linda Gardiner, Linda Josti, Elizabeth Dermanelian, and Sandra Ridel are neurocritical care nurses, Department of Nursing, Maine Medical Center. Barbara McCrum is a clinical research nurse coordinator, Neuroscience Institute, Maine Medical Center. John Dziodzio is a programmer/analyst and Patricia Lerwick is an intensivist physician, Department of Critical Care Services, Maine Medical Center. Paul Muscat is chief of neurology, Department of Medicine, Maine Medical Center. Robert Ecker and Jeffrey Florman are attending neurosurgeons, Neuroscience Institute, Maine Medical Center. Richard R. Riker is director of medical intensive care and David B. Seder is director of neurocritical care, Department of Critical Care Services, Maine Medical Center. Search for other works by this author on: This Site PubMed Google Scholar John Dziodzio, BA; John Dziodzio, BA Elizabeth K. Glisic and Gilles L. Fraser are clinical pharmacists in critical care and Ben Enos is a clinical pharmacist, Department of Pharmacy, Maine Medical Center, Portland, Maine. Linda Gardiner, Linda Josti, Elizabeth Dermanelian, and Sandra Ridel are neurocritical care nurses, Department of Nursing, Maine Medical Center. Barbara McCrum is a clinical research nurse coordinator, Neuroscience Institute, Maine Medical Center. John Dziodzio is a programmer/analyst and Patricia Lerwick is an intensivist physician, Department of Critical Care Services, Maine Medical Center. Paul Muscat is chief of neurology, Department of Medicine, Maine Medical Center. Robert Ecker and Jeffrey Florman are attending neurosurgeons, Neuroscience Institute, Maine Medical Center. Richard R. Riker is director of medical intensive care and David B. Seder is director of neurocritical care, Department of Critical Care Services, Maine Medical Center. Search for other works by this author on: This Site PubMed Google Scholar Barbara McCrum, RN; Barbara McCrum, RN Elizabeth K. Glisic and Gilles L. Fraser are clinical pharmacists in critical care and Ben Enos is a clinical pharmacist, Department of Pharmacy, Maine Medical Center, Portland, Maine. Linda Gardiner, Linda Josti, Elizabeth Dermanelian, and Sandra Ridel are neurocritical care nurses, Department of Nursing, Maine Medical Center. Barbara McCrum is a clinical research nurse coordinator, Neuroscience Institute, Maine Medical Center. John Dziodzio is a programmer/analyst and Patricia Lerwick is an intensivist physician, Department of Critical Care Services, Maine Medical Center. Paul Muscat is chief of neurology, Department of Medicine, Maine Medical Center. Robert Ecker and Jeffrey Florman are attending neurosurgeons, Neuroscience Institute, Maine Medical Center. Richard R. Riker is director of medical intensive care and David B. Seder is director of neurocritical care, Department of Critical Care Services, Maine Medical Center. Search for other works by this author on: This Site PubMed Google Scholar Ben Enos, PharmD; Ben Enos, PharmD Elizabeth K. Glisic and Gilles L. Fraser are clinical pharmacists in critical care and Ben Enos is a clinical pharmacist, Department of Pharmacy, Maine Medical Center, Portland, Maine. Linda Gardiner, Linda Josti, Elizabeth Dermanelian, and Sandra Ridel are neurocritical care nurses, Department of Nursing, Maine Medical Center. Barbara McCrum is a clinical research nurse coordinator, Neuroscience Institute, Maine Medical Center. John Dziodzio is a programmer/analyst and Patricia Lerwick is an intensivist physician, Department of Critical Care Services, Maine Medical Center. Paul Muscat is chief of neurology, Department of Medicine, Maine Medical Center. Robert Ecker and Jeffrey Florman are attending neurosurgeons, Neuroscience Institute, Maine Medical Center. Richard R. Riker is director of medical intensive care and David B. Seder is director of neurocritical care, Department of Critical Care Services, Maine Medical Center. Search for other works by this author on: This Site PubMed Google Scholar Patricia Lerwick, MD; Patricia Lerwick, MD Elizabeth K. Glisic and Gilles L. Fraser are clinical pharmacists in critical care and Ben Enos is a clinical pharmacist, Department of Pharmacy, Maine Medical Center, Portland, Maine. Linda Gardiner, Linda Josti, Elizabeth Dermanelian, and Sandra Ridel are neurocritical care nurses, Department of Nursing, Maine Medical Center. Barbara McCrum is a clinical research nurse coordinator, Neuroscience Institute, Maine Medical Center. John Dziodzio is a programmer/analyst and Patricia Lerwick is an intensivist physician, Department of Critical Care Services, Maine Medical Center. Paul Muscat is chief of neurology, Department of Medicine, Maine Medical Center. Robert Ecker and Jeffrey Florman are attending neurosurgeons, Neuroscience Institute, Maine Medical Center. Richard R. Riker is director of medical intensive care and David B. Seder is director of neurocritical care, Department of Critical Care Services, Maine Medical Center. Search for other works by this author on: This Site PubMed Google Scholar Gilles L. Fraser, PharmD Gilles L. Fraser, PharmD Elizabeth K. Glisic and Gilles L. Fraser are clinical pharmacists in critical care and Ben Enos is a clinical pharmacist, Department of Pharmacy, Maine Medical Center, Portland, Maine. Linda Gardiner, Linda Josti, Elizabeth Dermanelian, and Sandra Ridel are neurocritical care nurses, Department of Nursing, Maine Medical Center. Barbara McCrum is a clinical research nurse coordinator, Neuroscience Institute, Maine Medical Center. John Dziodzio is a programmer/analyst and Patricia Lerwick is an intensivist physician, Department of Critical Care Services, Maine Medical Center. Paul Muscat is chief of neurology, Department of Medicine, Maine Medical Center. Robert Ecker and Jeffrey Florman are attending neurosurgeons, Neuroscience Institute, Maine Medical Center. Richard R. Riker is director of medical intensive care and David B. Seder is director of neurocritical care, Department of Critical Care Services, Maine Medical Center. Search for other works by this author on: This Site PubMed Google Scholar ... Show more Paul Muscat, MD; Paul Muscat, MD Elizabeth K. Glisic and Gilles L. Fraser are clinical pharmacists in critical care and Ben Enos is a clinical pharmacist, Department of Pharmacy, Maine Medical Center, Portland, Maine. Linda Gardiner, Linda Josti, Elizabeth Dermanelian, and Sandra Ridel are neurocritical care nurses, Department of Nursing, Maine Medical Center. Barbara McCrum is a clinical research nurse coordinator, Neuroscience Institute, Maine Medical Center. John Dziodzio is a programmer/analyst and Patricia Lerwick is an intensivist physician, Department of Critical Care Services, Maine Medical Center. Paul Muscat is chief of neurology, Department of Medicine, Maine Medical Center. Robert Ecker and Jeffrey Florman are attending neurosurgeons, Neuroscience Institute, Maine Medical Center. Richard R. Riker is director of medical intensive care and David B. Seder is director of neurocritical care, Department of Critical Care Services, Maine Medical Center. Search for other works by this author on: This Site PubMed Google Scholar Richard R. Riker, MD; Richard R. Riker, MD Elizabeth K. Glisic and Gilles L. Fraser are clinical pharmacists in critical care and Ben Enos is a clinical pharmacist, Department of Pharmacy, Maine Medical Center, Portland, Maine. Linda Gardiner, Linda Josti, Elizabeth Dermanelian, and Sandra Ridel are neurocritical care nurses, Department of Nursing, Maine Medical Center. Barbara McCrum is a clinical research nurse coordinator, Neuroscience Institute, Maine Medical Center. John Dziodzio is a programmer/analyst and Patricia Lerwick is an intensivist physician, Department of Critical Care Services, Maine Medical Center. Paul Muscat is chief of neurology, Department of Medicine, Maine Medical Center. Robert Ecker and Jeffrey Florman are attending neurosurgeons, Neuroscience Institute, Maine Medical Center. Richard R. Riker is director of medical intensive care and David B. Seder is director of neurocritical care, Department of Critical Care Services, Maine Medical Center. Search for other works by this author on: This Site PubMed Google Scholar Robert Ecker, MD; Robert Ecker, MD Elizabeth K. Glisic and Gilles L. Fraser are clinical pharmacists in critical care and Ben Enos is a clinical pharmacist, Department of Pharmacy, Maine Medical Center, Portland, Maine. Linda Gardiner, Linda Josti, Elizabeth Dermanelian, and Sandra Ridel are neurocritical care nurses, Department of Nursing, Maine Medical Center. Barbara McCrum is a clinical research nurse coordinator, Neuroscience Institute, Maine Medical Center. John Dziodzio is a programmer/analyst and Patricia Lerwick is an intensivist physician, Department of Critical Care Services, Maine Medical Center. Paul Muscat is chief of neurology, Department of Medicine, Maine Medical Center. Robert Ecker and Jeffrey Florman are attending neurosurgeons, Neuroscience Institute, Maine Medical Center. Richard R. Riker is director of medical intensive care and David B. Seder is director of neurocritical care, Department of Critical Care Services, Maine Medical Center. Search for other works by this author on: This Site PubMed Google Scholar Jeffrey Florman, MD; Jeffrey Florman, MD Elizabeth K. Glisic and Gilles L. Fraser are clinical pharmacists in critical care and Ben Enos is a clinical pharmacist, Department of Pharmacy, Maine Medical Center, Portland, Maine. Linda Gardiner, Linda Josti, Elizabeth Dermanelian, and Sandra Ridel are neurocritical care nurses, Department of Nursing, Maine Medical Center. Barbara McCrum is a clinical research nurse coordinator, Neuroscience Institute, Maine Medical Center. John Dziodzio is a programmer/analyst and Patricia Lerwick is an intensivist physician, Department of Critical Care Services, Maine Medical Center. Paul Muscat is chief of neurology, Department of Medicine, Maine Medical Center. Robert Ecker and Jeffrey Florman are attending neurosurgeons, Neuroscience Institute, Maine Medical Center. Richard R. Riker is director of medical intensive care and David B. Seder is director of neurocritical care, Department of Critical Care Services, Maine Medical Center. Search for other works by this author on: This Site PubMed Google Scholar David B. Seder, MD David B. Seder, MD Elizabeth K. Glisic and Gilles L. Fraser are clinical pharmacists in critical care and Ben Enos is a clinical pharmacist, Department of Pharmacy, Maine Medical Center, Portland, Maine. Linda Gardiner, Linda Josti, Elizabeth Dermanelian, and Sandra Ridel are neurocritical care nurses, Department of Nursing, Maine Medical Center. Barbara McCrum is a clinical research nurse coordinator, Neuroscience Institute, Maine Medical Center. John Dziodzio is a programmer/analyst and Patricia Lerwick is an intensivist physician, Department of Critical Care Services, Maine Medical Center. Paul Muscat is chief of neurology, Department of Medicine, Maine Medical Center. Robert Ecker and Jeffrey Florman are attending neurosurgeons, Neuroscience Institute, Maine Medical Center. Richard R. Riker is director of medical intensive care and David B. Seder is director of neurocritical care, Department of Critical Care Services, Maine Medical Center. Search for other works by this author on: This Site PubMed Google Scholar Am J Crit Care (2016) 25 (2): 136–143. https://doi.org/10.4037/ajcc2016486 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Share Icon Share Facebook Twitter LinkedIn Email Tools Icon Tools Cite Icon Cite Get Permissions Citation Elizabeth K. Glisic, Linda Gardiner, Linda Josti, Elizabeth Dermanelian, Sandra Ridel, John Dziodzio, Barbara McCrum, Ben Enos, Patricia Lerwick, Gilles L. Fraser, Paul Muscat, Richard R. Riker, Robert Ecker, Jeffrey Florman, David B. Seder; Inadequacy of Headache Management After Subarachnoid Hemorrhage. Am J Crit Care 1 March 2016; 25 (2): 136–143. doi: https://doi.org/10.4037/ajcc2016486 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search nav search search input Search input auto suggest search filter All ContentAmerican Journal of Critical Care Search Advanced Search BackgroundHeadache profoundly affects management of spontaneous subarachnoid hemorrhage but is poorly characterized.ObjectiveTo characterize headache after spontaneous subarachnoid hemorrhage.MethodsMedical records of patients with Hunt and Hess grades I–III subarachnoid hemorrhage admitted from 2011 to 2013 were reviewed. Demographics, clinical and radiographic features, medications, and pain scores were recorded through day 14 after hemorrhage. Headache pain was characterized on the basis of a numeric rating scale and analgesic use. Severe headache was defined as 2 or more days with maximum pain scores of 8 or greater or need for 3 or more different analgesics for 2 or more days. Univariate and multivariable models were used to analyze factors associated with severe headache.ResultsOf the 77 patients in the sample, 57% were women; median age was 57 years. Severe headache (73% overall) was associated nonlinearly with Hunt and Hess grade: grade I, 58%; grade II, 88%; and grade III, 56% (P = .01), and with Hijdra score: score 0–10, 56%; score 11–20, 86%; score 21–30, 76% (P = .03). By univariate analysis, patients with low Hijdra scores were less likely to have severe headache (27% vs 57%; P = .02). In a multivariable model, younger age and higher Hijdra score tended to be associated with severe headache.ConclusionsHeadache after spontaneous subarachnoid hemorrhage was often severe, necessitating multiple opioid and nonopioid analgesics. Many patients reported persistent headache and inadequate pain control. ©2016 American Association of Critical-Care Nurses2016 You do not currently have access to this content.
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