How to Assess Headaches and Dizziness

Headaches are a common medical complaint for men, women and children. Headaches and dizziness can be difficult for medical personnel, such as first responders, EMTs and nurses, to assess when first interviewing a patient with these complaints. Asking the right questions and performing the proper examinations can make assessment of headache and related symptoms more effective and useful for subsequent patient treatment.

Things You'll Need

• Patient interview form or chart

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Instructions

• 1

  Interview the patient about her symptoms related to headache and dizziness. Ascertain when the complaint started, what makes symptoms worse or better, whether associated symptoms (such as vomiting or fever) are present, and how severe the headache pain is. Use a pain scale, with 0 being no pain and 10 being the worst pain, to determine the severity of the patient's headache.

• 2

  Ask the patient about his medical history to determine whether he has been diagnosed with an associated condition, such as migraine disorder or neurological problems. Inquire whether the patient has experienced any trauma, such as a motor vehicle accident, fall or assault, that could have resulted in his complaints.

• 3

  Ask about any medications that the patient may be taking, including all over-the-counter medications and any prescriptions that may be new to the patient. Remind her that herbal and homeopathic remedies are considered medications and that she should inform you if she takes any.

• 4

  Perform a physical examination of the patient. Check the patient's head, eyes, ears, mouth and neck for relative findings, such as bruising or signs of trauma. Complete a full physical examination, including heart and lung sounds, abdomenal examination and skin check. Have the patient show you where the headache pain is by pointing to the location on his head.

• 5

  Perform a basic neurological examination. First, ask the patient if she has any known neurological disorders, and, if so, establish what her neurological deficits may be, such as slurred or slow speech. Inspect her pupils for size and reactivity to light. Ask her to hold her arms out in front of her for 5 seconds, unassisted. Then, ask her to hold her right arm out in front of her and to bend her arm at the elbow, bringing her index finger toward her face until it touches her nose. Determine the need for further neurological testing based on the results.

• 6

  Consider alternative causes for the headache and dizziness symptoms, such as cardiac problems or low blood sugar. Provide additional tests, up to your level of practice, to help uncover underlying conditions. Consult with a higher-level provider about your findings and discuss further testing and treatment options.