Date of Completion

Spring 5-1-2015

Thesis Advisor(s)

Arlene Albert, Ph.D.

Honors Major

Molecular and Cell Biology

Disciplines

Clinical Epidemiology | Pediatrics

Abstract

Headaches are a common complaint for children presenting to the Emergency Department (ED) at Connecticut Children’s Medical Center (CCMC). Currently, there is little published regarding a standard treatment plan for pediatric headaches. The purpose of this study is to determine which medications are most commonly utilized and which are most effective in managing pediatric headaches. Differences in management of acute and chronic headaches in the ED at CCMC were examined. A retrospective chart review was conducted of all children who presented to the ED from January 1 to March 31, 2013 with a chief complaint or discharge diagnosis of “headache” or “migraine”. Data collection included medications administered in the ED, intensity of headache (pain score scaled 1-10) before and after medication administration, and disposition (home or admitted). Acute headaches were defined as headaches lasting 1-7 days and chronic headaches as lasting more than 7 days. Of 165 children who presented to the ED at CCMC with headaches in 2013, 72.7% presented with acute headaches, while 27.3% presented with chronic headaches. The most common medications used to manage headaches in this ED are Ibuprofen, Toradol, IV fluid (NaCl), Reglan and Acetaminophen. It cannot be assumed that one medication brought the pain score down because multiple drugs were administered. Therefore, efficacy of individual drugs could not be determined. Ibuprofen was used more frequently to manage acute headaches, while Reglan and Benadryl were used more often for chronic headache management. This study can be a basis for future prospective studies that examine medication efficacy in managing pediatric headaches, ultimately resulting in the development of treatment guidelines for the ED.

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