Headache – Basic Assessment and Advice

🔍 What to Ask the Caller

To help determine the seriousness of the headache, ask:

• Where is the headache located?
  – One side, behind the eyes, across the forehead, at the back of the head

• How severe is the pain (1–10 scale)?

• When did it start? Is it constant or does it come and go?

• Is this a new type of headache, or have they had similar headaches before?

• Any other symptoms?
  – Fever, nausea, vomiting, visual changes, sensitivity to light/sound, dizziness, confusion

• Have they taken any medication (e.g., paracetamol, ibuprofen)? Has it helped?

• Any known conditions?
  – E.g., migraines, high blood pressure, sinus infections

• Any recent illness, injury, stress, or lack of sleep?

• Any recent head trauma or accidents?

✅ When to Reassure – Mild or Known Headaches

If symptoms are mild, typical for the caller, and there are no red flags, it's likely safe to reassure and recommend self-care:

• Encourage rest in a quiet, dark room

• Hydration is key – headaches often result from dehydration

• Use over-the-counter pain relief (e.g., paracetamol or ibuprofen, if appropriate)

• Cold compress on forehead or neck may help tension-type headaches

• Avoid screen time and bright lights for a few hours

"Since this sounds like a common or mild headache, try resting and staying hydrated. If anything changes or worsens, please call back or see your doctor."

🚨 When to Escalate or Refer

Headaches can sometimes signal serious issues. Escalate if the caller mentions:

• Sudden, severe headache (“worst ever”)

• Headache following a recent head injury or fall

• Headache with fever, stiff neck, or sensitivity to light

• Confusion, fainting, or trouble speaking

• Vision changes or double vision

• Numbness, weakness, or difficulty walking

• New headache in someone over 50 or with cancer/immunocompromised

• Headache that wakes them up at night or gets worse when lying down

“Your symptoms could indicate something more serious, and I strongly recommend you speak to a doctor or visit urgent care as soon as possible.”

📌 Important Notes

• Do not diagnose (e.g., don’t assume it’s a migraine or sinus issue)

• Avoid false reassurance – always check for red flags

• Document any triggers, symptoms, and advice given

• Refer to escalation flow or clinical lead if uncertain