Jel,
The Migraine Association of Ireland gave a talk at the Irish Association for
Emergency Medicine back in 2004 where they launched their latest information
campaign "A guide to the diagnosis and management of migraine in the
Emergency Department" I couldn't find a copy online but the speaker was
quite insistent that we would not treat migraineurs (himself included) with
opiates, be it codeine or morphine.
Personally, I can't think of migraineurs in any of the places where I worked
who would be frequent attenders requesting opiates. Wouldn't be personal or
departmental practice to prescribe them either, as an aside.
Jason
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Jel Coward
Sent: 16 August 2010 19:20
To: [log in to unmask]
Subject: opioids for migraine in the A+E depts
Hi all
Not wanting to start a 'it's ok, it's not ok' war here.
My personal observation and belief is that doling out opioids for
migraine via the emergency dept is, in general, not a good idea - for
the patients and the dept.
I will add that the practice of "come into emerg and get 'the fix' for
migraine" seems to be a much more N American concept that UK but I have
been out of the UK since 2000 and and wondering what the current
thoughts/practices are.
It seems that lots of emerg depts have 'regulars' who turn up for
opioids for migraine.
Feel free to argue the opioid/non-opioid in migraine issue ......but
that is not the intended point of this thread.
I know of one emerg dept in British Columbia who introduced a 'no
opioids for migraine' policy - and it made a huge difference to the
numbers of reported migraineurs presenting for treatment (which might be
considered odd since other treatments, available in a medical facility
only, have been shown to be as effective as opioids for this miserable
condition).
I am wondering whether opioid treatment of migraine in the emergency
dept a common thing in the UK? (with 'regulars' coming in etc)
Please note, I think that migraine is one of the most horrible
afflictions, and that neither this post or my thoughts are born of any
contrary idea.
Cheers all
--
Jel
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