How Do I Know If I Should Go To The Er
If your migraine is too severe and the treatments listed above do not work, you may choose to go to the ER. If you decide to go to the ER, be sure to have someone else drive you there.
The symptoms of a migraine can be confused with the symptoms of a stroke. You should go to the hospital right away if:
- You have an extremely severe headache
- You have speech, vision, movement, or balance problems that are new or different from symptoms you have had before with your migraines
- You have a stiff neck or fever with your headache
- The headache starts suddenly, like a thunderclap, especially if you are over age 50
Helping You Find Immediate Relief
Most likely than not, if you are suffering from a migraine, headache, or chronic migraine, you will want to find immediate relief for your pain symptoms. Over-the-counter pain killers can be a temporary solution, however, if your condition is severe you may need to get in touch with a medical professional as soon as possible. Chronic migraines can be especially unbearable and may even cause agonizing discomfort.
If you require relief from severe headaches or migraines, get in touch with our highly experienced team at Advanced ER. We have a wide array of services and treatments to get you back to optimal health.
Not All Hospitals And Emergency Rooms Are Alike Some Are Lifesavers
Although it’s a fairly common complaint among ER patients, the space and process are designed to prioritize and treat life-threatening conditions, not Migraine. And to be fair, sometimes they do everything right.
“I have been to our local hospital here several times for a migraine. Couldn’t have been better cared for. The nurses turned the lights off and gave me a cool cloth to put over my eyes while I waited for the Dr. He gave me a shot of Imitrex and I have been taking the pills ever since. Changed my life. I was told that I would never have to wait out in the waiting room, there was always a cool dark room to wait in. Also, when I get the chills as I often do with migraines, they bring me heated blankets.” Roberta C.
“They know me, and someone way back must’ve educated the ER staff I’ve only had 1 bad experience on the 16 years I’ve been having these. It happened to be a just awful nurse that was showing her need to retire ” Hollyanna C.
“Luckily I get treated pretty well at the ER for migraines. Give me some meds and a drip and 5 mins later I feel great. With all the other “patients” that go to the ER they know I’m for real. Around here it’s a lot of people who think they are pregnant, or have a toothache that go to the ER. Mainly because they don’t have insurance.” Meg W.
“My last visit to the ER for migraine was very straightforward and helpful. Checked out, IV fluids, Toradol, Compazine actually was a good experience .” June B.
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Why Patients With Migraine Go To The Er
The most common reason is actually a concern that there is a serious underlying cause such as a hemorrhage, stroke, brain tumor, or infection, said Dr. Hamilton. Another common reason that patients go to the emergency room with migraine is that the pain has just become so severe and difficult to treat at home that they need stronger treatments that can be administered in the emergency room.
Signs To Go To The Emergency Room For A Migraine
The reason most people with migraine end up in the emergency room is that they fear their symptoms may be a sign of another serious health condition or the pain has become unmanageable. If the pain begins suddenly, it is more intense than usual, causes numbness, weakness, visual loss, or any unusual or new symptomsyou need to get checked out by a doctor. Pain can be a frightening sensation because it can feel like you are out of control with no resources to improve the situation.
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What Is Migraine Headache
A migraine is an intense headache that is often characterized by a pulsing or throbbing pain in one place and it often lasts for several hours or a few days. The pain may also be accompanied by vomiting, nausea, or sensitivity to light and sound, and it may be preceded by tingling in the arms or legs, blind spots or flashes of light.
Some people are hesitant to visit an emergency room for migraine or a bad headache, but it can be debilitating and extremely painful. If you are suffering from a severe headache, you may need medical attention from an emergency room physician.
Migraines can cause severe pain or painful pulsing sensation. It normally occurs on one side of the head and is often accompanied by vomiting, sensitivity to light and sound, and nausea.
Migraine attacks can last anywhere from hours to days and the pain could be so severe that sufferers are unable to function during the attacks.
What Are The Downsides Of Going To The Emergency Room With A Migraine
So, we know E.R. staff will be able to treat your migraine faster and more effectively than you could at homeâand when youâre in debilitating pain, the only thing that matters to you might just be making it stop as soon as possible.
But if thatâs the case, you should also take into account the amount of time you might spend waiting before you get that treatment. Thereâs really no way to know how long youâll have to wait, and the emergency room is the last place youâd want to be during a migraine.
Whyâs that? âWell, the emergency room is often a very loud, bright, chaotic place that treats a large number of patients with a wide range of conditions including heart attacks, strokes, and drug overdoses,â Dr. Bain explains. âTo put it bluntly, migraine patients are rarely a priority in the ER.â
And in the times of COVID-19, those other patients arenât just another source of unbearably loud sounds. Theyâre also a legitimate risk to your healthâand if you have COVID-19 and donât know it, you could be a danger to them. You shouldnât let the fear of coronavirus exposure stop you from seeking emergency care if you need it, but you should consider whether the treatment youâll receive is worth the risk youâre taking.
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What Will They Do For Me There
First, the physician will evaluate you and check that there is no other cause for the severe headache. If tests are needed they can be done.
Many treatments have been studied for migraine in the Emergency Room context. The advantage of the ER is to use IV medicines. Some medications used include:
- Hydration with IV fluids
- Anti-emetics: Gravol, metoclopramide, prochloperazine, odansetron
- NSAIDs: ketorolac can be given IV
- Cortisone can be used, usually to prevent recurrence
- Opioids should be avoided but are still used too frequently
Some physicians in the ER can also do nerve blocks to treat the attack. Occipital nerve blocks may work for some people.
If the situation is very difficult, a neurology consult can be required.
How Long Is Too Long For A Migraine
D for disabling intensity. Without effective treatment, migraine attacks usually last for four to 24 hours. When youre suffering a migraine, even four hours is far too long and thats why early treatment for a migraine is so important.
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When To Get Medical Advice
You should see a GP if you have frequent or severe migraine symptoms.
Simple painkillers, such as paracetamol or ibuprofen, can be effective for migraine.
Try not to use the maximum dosage of painkillers on a regular or frequent basis as this could make it harder to treat headaches over time.
You should also make an appointment to see a GP if you have frequent migraines , even if they can be controlled with medicines, as you may benefit from preventative treatment.
You should call 999 for an ambulance immediately if you or someone you’re with experiences:
- paralysis or weakness in 1 or both arms or 1 side of the face
- slurred or garbled speech
- a sudden agonising headache resulting in a severe pain unlike anything experienced before
- headache along with a high temperature , stiff neck, mental confusion, seizures, double vision and a rash
Alternatives To Going To The Er With A Migraine
Given all the unpleasant and dramatic stories about ER treatment, you may be wondering: what’s the alternative? If it’s a scary attack with new complications, going to the ER with a Migraine is your safest bet. If it’s an intractable Migraine that won’t respond to treatment at home, you have a few options.
When Does A Migraine Become An Emergency
It is advised that you seek urgent care for migraines if you are experiencing symptoms that are unfamiliar to you. Here is a list of symptoms you should never ignore.
- loss of vision
- high fevers
That is quite a long list but if you suffer from migraines you know that you can experience many of these all at once. That is why migraines are so uncomfortable and painful.
If you have an ongoing critical medical condition, are pregnant or have a life-threatening sexually transmitted disease, you will need to treat any mysterious occurrence of migraine as an emergency.
You will want to ensure that there are no serious underlying illnesses that are causing severe migraines or that there is no likelihood of any other serious illnesses, such as a stroke, developing.
Sudden And Severe Headaches
Most headaches come on gradually, and if youre paying attention to your body, you can stop the headache from getting worse. Serious headaches come on quickly and are extremely intense.
If you would describe your headache as the worst headache of your life, you should go to an emergency room. It could be a sign of a life threatening condition.
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My Employer Does Not Understand That My Migraine Attacks Can Be Severe I Have Been Asked To Go To The Er Only To Get A Doctor Note I Can Usually Manage At Home What Can I Do
Act like a Migraine Warrior. Get a note from your physician explaining that migraine can be severe and disabling. The World Health Organization recognizes that severe migraine attacks are as disabling as being quadriplegic. Your physician can review your situation and explain to the employer that asking for a useless ER visit is not the optimal way to make you feel better and is a poor use of health care resources.
To read more:
Orr SL, Aube M, Becker WJ, Davenport WJ, Dilli E, Dodick D, et al. Canadian Headache Society systematic review and recommendations on the treatment of migraine pain in emergency settings. Cephalalgia. 2014.
What Patients Can Expect In The Er And How Can They Can Advocate For Better Treatment And Care
Patients with migraine who begin to experience severe and unusual symptoms should visit the ER to get treatment and seek relief from their symptoms. However, ER physicians do not specialize in headache medicine, so the medication and treatment they provide may not be as effective as a trip to a neurologist or headache specialist. Dr. Katherine Hamilton, Headache Fellow at the Montefiore Headache Center, explains when is the appropriate time for patients with migraine to go to the ER and what they can expect there.
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A Guide For Migraine Patients When In The Emergency Room
When you are in the throes of a migraine attack, harnessing the energy to leave the house requires a gargantuan effort. So, you can bet that if a migraine patient presents at a local emergency room, its because they need helpalthough due to the ongoing stigma associated with migraine, many patients wont receive the attention they deserve. If the pain you are experiencing prompts an ER visit, the following guide will help you ensure that your visit results in the care you deserve.
You’re Not Exactly Fine When You Leave
In absence of a cure for Migraine, you’re going to get medication. And lots of it. Enough to knock out a horse. Better not make plans for tomorrow that’s time for your Migraine hangover, aka postdrome.
“They give you “abortive meds.” Knock you out, send you home. Then you’re in a medicated induced coma for the rest of the day. Then you wake up the next day still having the same migraine.” Jaselle H.
“Shot me up with meds so strong I couldn’t even move.” Victoria S.
“Last time I was in the ER for a migraine they gave me the wrong meds which were too strong for me and I had a heart attack!! I went thinking they would make me better but instead it only made it worse!!” Jessica A.
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Prepare To Face The Stigma
Unfortunately, those who end up in the emergency room for their migraine are sometimes greeted with hostility instead of empathy and compassion. It is not uncommon to hear of migraine patients being treated disdainfully, as if they are exaggerating their symptoms. Their invisible pain is often not taken seriouslysome are even accused of being drug seekers, inventing their condition to score medication. Dont let this discourage you. Be your own advocate and remember: Migraine is a disabling disease, and you deserve proper support and treatment.
How Are Migraines Treated In The Er
Many medicines are used to treat severe migraine headache pain in the ER, including those listed on the next page. The ER doctor may also give you other medicines for nausea and may treat you for dehydration .
Medicines for Pain Relief
Researchers found that the medicines listed below work to lessen or stop migraine pain. Nearly all of these medicines are given as a shot or through an intravenous tube in your arm. Some NSAIDs can also be taken by mouth.
|Neuroleptics and antiemetics are medicines that change the way certain chemicals act in your brain. Some of these medicines may also treat nausea and vomiting.|
|Sumatriptan||Sumatriptan is a headache medicine that narrows the blood vessels in your brain.Note: People with heart problems, such as narrowing or hardening of blood vessels in the heart, should not take this medicine.|
|NSAIDs||NSAIDs are medicines that relieve pain.|
|Opioids||Opioids are medicines that relieve pain. But, these medicines are rarely used for migraines because of possible side effects and the fact that other medicines work well to relieve migraine pain.Note: Taking opioids repeatedly to relieve pain can lead to overuse. Opioids can be addictive.|
|Dihydroergotamine||Dihydroergotamine is a headache medicine that narrows the blood vessels in your brain.|
Medicines To Stop the Migraine From Coming Back
The doctor may also give you a medicine to help stop the migraine from coming back within the next day or two.
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Challenges Patients With Migraine Face In The Er
The emergency room can be a really challenging place for a patient with a migraine, said Dr. Hamilton. Its a chaotic environment with noise, bright lights, odors which may be offensive its sensory overload the very last thing a patient in the midst of a migraine attack needs or wants.
In the emergency room, people with migraine face unique challenges. ER doctors approach neurological problems with caution, so people with migraine should generally expect testing, including CT scans, and possibly a spinal tap . Patients are likely seeing new doctors who dont know their medical history and what generally works best for them, which can lead to less effective treatment. Opioids and narcotics are commonly prescribed to patients with migraine, even though theyre not as effective as other alternatives, and come with risks.
Migraine is often not recognized as a serious problem in the emergency department and patients may not get the attention that is expected or deserved, said Dr. Hamilton.
What Do Doctors Prescribe For Migraines
Triptans. These are prescription drugs such as sumatriptan and rizatriptan are prescription drugs used for migraine because they block pain pathways in the brain. Taken as pills, shots or nasal sprays, they can relieve many symptoms of migraine.
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How Patients Can Advocate For Their Care In The Er
Know your migraine and know which treatments have worked for you in the past, said Dr. Hamilton. Especially if youve been to the emergency room before, it can be very helpful to come up with a plan of attack for what you should do if there is a next time that you have to go.
She suggests that patients work with their neurologist or headache specialist to figure out a rescue plan designed to keep patients out of the ER. When the rescue options fail, work with your doctor and draft a treatment plan that is then signed by the doctor. This is helpful when its hard for patients to think straight and fully communicate during an attack.
I think we could potentially lower the number of people who are going to the emergency room if you know exactly when to be concerned and if you have a rescue or backup plan if your usual treatments dont work, said Dr. Hamilton.
The American Migraine Foundation has an extensive collection of information related to migraine and headache disorder in the emergency room. Find more information in our Resource Library, and use the Find a Doctor database to connect with a specialist near you.
Reviewed for accuracy by the American Migraine Foundations subject matter experts, headache specialists and medical advisers with deep knowledge and training in headache medicine. to read about our editorial board members.