This post discusses a structured approach to reading C-spine CT scans in trauma and accompanies Podcast Episode 32.0
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The ABCS of Reading C-Spine CTs
Journal Review
NEXUS Chest Decision Instruments
CT use in the evaluation of trauma patients has risen dramatically in recent years. “Pan-scan” (CT scan from head through pelvis) is used routinely in many trauma centers in spite of the American College of Surgeons inclusion of avoidance of routine whole body CT in trauma in it’s Choosing Wisely recommendations. Although prior studies have demonstrated increased identification of traumatic pathology with “pan-scanning” there has not been a concurrent demonstration of decreased morbidity or mortality.
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Core
Hypocalcemia
Hypocalcemia is infrequently seen in the ED but management should focus on supplementation and searching for the underlying cause
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Journal Review
Idarucizumab for Reversal of Dabigatran
Dabigatran Site of Action (www.medscape.com)
The burdens associated with the use of traditional anticoagulants such as subcutaneous heparins and oral vitamin K antagonists (VKAs) have spurred the popularity of non-vitamin K oral anticoagulants (NOACs) for stroke prevention in patients with nonvalvular atrial fibrillation and for the prevention and treatment of venous thromboembolism.
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Core
Proximal Humerus Fracture
Proximal humerus fractures are a common injury seen in the ED. We review the imaging, complications and management.
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Journal Review
ED Initiated Buprenorphine/Naloxone Treatment for Opioid Dependence
The harmful effects of opioid dependence are well known to ED providers and include overdose, high risk behaviors, and psychosocial instability. Patients with opioid dependence represent a significant proportion of ED visits annually, whether for overdose, addiction/withdrawal treatment, or general medical and psychiatric care. Previous studies have shown that buprenorphine/naloxone, a partial opioid agonist + antagonist,
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Core
Clavicle Fractures
Fractures of the clavicle, commonly referred to as the “collarbone”, are a common but important diagnosis to make
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