Overview
- The update, published in Headache, revises the 2016 emergency‑department guidance using evidence from 26 clinical trials.
- Greater occipital nerve blocks receive a must‑offer recommendation as an effective and safe option for acute migraine attacks.
- Intravenous prochlorperazine is elevated to level A status for ED treatment of migraine, though availability varies across hospitals.
- Authors say broader use can improve discharge outcomes and reduce opioid reliance, with the guidance advising against opioids for headache.
- Implementation will require clinician training, supplies, and ED order‑set changes, with outreach underway to national groups including the Canadian Headache Association.