During a secondary assessment of a patient with a severe headache, what should you do first?

In a secondary assessment of a patient presenting with a severe headache, the first step should be to thoroughly assess the patient to identify any underlying issues that may not have been addressed during the primary assessment. This includes conducting a head-to-toe examination to look for any signs of trauma or neurological deficits, gathering a SAMPLE history (which stands for Symptoms, Allergies, Medications, Past medical history, Last oral intake, and Events leading up to the present condition), and obtaining vital signs to establish a baseline for the patient's condition.

This comprehensive approach allows you to gather critical information that can inform treatment plans and decision-making. Identifying any additional complications or concerns is essential before proceeding to interventions like administering pain relief, which may be inappropriate if there are significant underlying issues that need to be addressed first.

Calling for advanced support may be necessary in certain situations, but it usually follows the thorough assessment to provide those advanced practitioners with the full picture of the patient's condition. Monitoring the patient's breathing is certainly important, but it is typically a part of initial assessments rather than the first step in a detailed secondary assessment focusing on a severe headache.