https://doi.org/10.4081/scenario.2025.597
Evaluation of headache by the emergency room nurse. Narrative literature review of the main red-flags and triage models
Submitted: 18 June 2024
Accepted: 30 December 2024
Published: 19 March 2025
Accepted: 30 December 2024
Abstract Views: 492
PDF (Italiano): 149
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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Introduction: Headache represents a frequent condition in patients who are admitted to the Emergency Room (ER), but the evaluation of symptoms is based on experience and it’s not always done in codified way. The Red-Flags represent the key points to be used in the evaluation of symptoms, but their presence is not always contemplated in the main Triage models.
Materials and methods: A literature review was conducted on 11 databases, aimed at identifying the main Red-Flags relating to headache and their presence in the main Triage models.
Results: From the 19 results included, it emerged that the SNNOOP10 Red-Flags – syncope, convulsions and carbon monoxide exposure – are useful in identifying pathologies secondary to headache. On the other hand, pain, neck stiffness, accentuation of headache, fever and progressive/atypical headache prove to be of unclear usefulness. Blood pressure and blood tests can be helpful in identifying serious causes. Compared to the Triage models, the flow chart of the Triage Training Group is the one that most includes the main Red-Flags identified.
Conclusions: Headache represents a frequent condition in patients who are admitted to the ER and considering the Red-Flags is essential for a correct evaluation of the symptoms.
Keywords: Triage, Headache, Emergency Room, Nurse, Red-Flag
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How to Cite
Subazzoli, D., Mainolfi, F., & Bagattoni, V. (2025). Evaluation of headache by the emergency room nurse. Narrative literature review of the main red-flags and triage models. Scenario® - Il Nursing Nella Sopravvivenza, 42(1). https://doi.org/10.4081/scenario.2025.597
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