Articles: trauma.
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ABSTRACTBackground:Minor head trauma in young children is a major cause of emergency department visits. Conflicting guidelines exist regarding radiologic evaluation in such cases. Objective:To determine the practice pattern among Canadian emergency physicians for ordering skull radiographs in young children suffering from minor head trauma. ⋯ The minimum sensitivity deemed acceptable for such a rule was 98%. Conclusion:Canadian emergency physicians have a wide variation in skull radiography ordering in young children with minor head trauma. This variation, along with the need expressed by physicians, suggests that further research to develop a clinical decision rule is warranted.
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Detection of occult injuries, which are not easily recognized and are life-threatening, in motor vehicle crashes (MVCs) is crucial in order to reduce fatalities. An Occult Injury Database (OID) was previously developed by the Center for Transportation Injury Research (CenTIR) using the National Automotive Sampling System Crashworthiness Data System (NASS-CDS) 1997-2001 which identified occult and non-occult head, thorax, and abdomen injuries. The objective of the current work was to develop an occult injury model based on underlying injury characteristics to derive an Occult Score for common MVC-induced injuries. ⋯ Of the considered injuries, it was determined that 54% of head, 26% of thorax, and 23% of abdominal injuries were occult injuries. No occult injuries were identified in the face, spine, upper extremity, or lower extremity body regions. The Occult Score generated can be useful in advanced automatic crash notification research and for the detection of serious occult injuries in MVCs requiring prompt treatment at a trauma center.
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Clinical questionWhat is the prevalence of immediate and incidence of delayed intracranial hemorrhage in patients with blunt head trauma who use warfarin or clopidogrel?Article chosenNishijima DK, Offerman SR, Ballard DW, et al. Immediate and delayed traumatic intracranial hemorrhage in patients with head trauma and preinjury warfarin or clopidogrel use. Ann Emerg Med 2012;59:460-8.e7. Study objectiveTo assess the prevalence of immediate and the cumulative incidence of delayed traumatic intracranial hemorrhage in patients using warfarin or clopidogrel.
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Splenic injury is normally associated with trauma, but spontaneous splenic rupture has been described in various systemic diseases. ⋯ Non-traumatic splenic rupture is a rare complication of oral anticoagulation.