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Foundations: Headache – Part 2

Mel Herbert, MD and Stuart Swadron, MD
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21:33
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Part 2 of Foundations: Headache

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Marilee B., APNP -

??Where are summary notes for all of part 2...

Mizuho M., DO -

Hi marilee,
first off my apologies for the very late reply. For some reason your comment got missed early on? We are getting better about timely responses now.
You should be able to find summary notes for part 2 under DOWNLOADS within the Headache section on the written summary. I hope that helps. Thanks.

Kimberly E. -

Hi,
I have a question in regards to the meningitis section. I have worked in neurosurgery and have seen meningitis in more of a hospital setting and not urgent care. What are the risks versus benefits of giving prophylactic antibiotics? Ideally we would want a lumbar puncture first before starting antibiotics right? Will giving the 2g of ceftriaxone make treatment more difficult later? Also, would immunocompromised patients have any resistnce for ceftriaxone? Thanks!

Mike W., MD -

Kim, thx for the comment - if you suspect bacterial meningitis, and there is a prolonged transport time, definitely give the ceftriaxone 2g as the recommendations for starting treatment are 30 minutes, and an LP can be done in the ED. In regard to proplylactic ATB, I would advise AGAINST. If you think the pt may have bacterial meningitis (or a concerning 'other' meningitis such as fungal/croptococcal, viral (herpes), the pt needs transported to the ED for an LP for a definitive diagnosis. Thx for the comment!

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Facial Swelling, Headaches, and Getting Sued! Full episode audio for MD edition 212:51 min - 248 MB - M4AUrgent Care RAP 2015 August Summary 1 MB - PDF