RED FLAG FRIDAY: Headaches

This is an awesome tip that I learned from Dr. Jennifer Keehbauch (who is the Associated Director here at Florida Hospital Family Medicine Residency). This tips was given as part of our "Learning Center" teaching series which our faculty personally do for our residents. Enjoy!


      S     =     Systemic Signs (such as fever, meningismus, or weight loss)


      N     =     Neurologic Signs or Symptoms (slurred speech, double vision, abnormal neuro exam)


      O     =     Onset Sudden ("worst headache of life", thunderclap)


      O     =     Onset < 5 years or > 50 years (don't forget about temporal arteritis)


      P      =    Progression of Existing Headache (increased severity or frequency or change in quality)


If a patient has any of these symptoms, consider imaging to look for a secondary cause of the headache. 

Tips on Inpatient Geriatric Delerium

This is an awesome tip that I learned from Dr. Mina Zeini (who is also faculty here at Florida Hospital Family Medicine Residency). This tips was given as part of our "Learning Center" teaching series which our faculty personally do for our residents. Enjoy!

     1. Use the CAM (Confusion Assessment Method)

           1. Must have acute onset and fluctuating course  AND
           2. Must have Inattention

               PLUS

           3. Disorganized thinking

               OR

           4. Altered level of consciousness

     2. Find out the CAUSE!

     3. Do NOT RESTRAIN!!! (increases delirium)

     4. Haldol at low dose (0.25 to 0.5 mg IV) is the first line therapy (discontinue as you find out cause)

     5. TRY TO AVOID BENZOS (it worsens delirium)