Dr. Travnicek presented with the first headache of her life. That's when s**t got REAL. A harrowing story that offers lessons for how to fix healthcare.
zdoggmd.com
In EM, you're trained, "All 'first, worst, or thunderclap" headaches get a CT and LP. So, sudden onset worst headache of your life isn't a "wine headache" unless you've got a negative head CT and LP negative for RBC,
even if head has improved (because warning headaches from sentinel bleeds are common). It's a subacrachnoid hemorrhage until proven otherwise. Most turn out not to be, but there's only one way to rule it out, and if you miss it, young people that walked in awake and alert, leave in a body bag. And you get sued, and lose every time.
If the patient refuses the CT, or more commonly the LP, then that's on them, but you tell them what is indicated and recommended and document that, plus informed refusal.
I didn't listen to the interview, but very few life threatening causes of headache are going to slip by a CT
and LP, in combination. And they're two very quick, easy and safe tests to do. So, without having listened to the interview and from reading the headline only, lemme guess: Subarachnoid hemorrhage from ruptured aneurysm.
