Patients with acute headache vary in presentation and severity, which can make initial assessment challenging. Prehospital care should begin with obtaining vital signs and assessing level of consciousness, including the Glasgow Coma Scale (GCS) score. Stabilization may include airway management, depending on the patient’s clinical status, training of the prehospital emergency care provider, and distance to the ED. A brief neurological examination should be performed to assess for obvious focal neurologic deficit, and a formal stroke scale should be used to assess severity of symptoms.77
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