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Published byBerniece Cooper Modified over 8 years ago
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Minor head injury
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What is it? Head injury GCS >12 Adults (16-65): LOC, amnesia, confusion Kids ??
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Who to scan (adults) Those over 65, anticoagulated GCS <15 at 2 hours post Signs of basilar skull fracture ?2 or more vomits ?Retrograde amnesia to event >30 minutes ??Dangerous mechanism – Struck by motor vehicle – Ejected from motor vehicle – Fall >3 feet or 5 stairs – Otherwise keep for ~4 hours then discharge
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Kids A:<2, b:≥2 Are they normal now? Do they have a big bump that is not on the front Were they hit hard LOC Vomit Headache
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No scanning,
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Anticoagulated, negative CT? Home, right? Don’t think too hard about this article: MANAGEMENT OF MINOR HEAD INJURY IN PATIENTS RECEIVING ORAL ANTICOAGULANT THERAPY: A PROSPECTIVE STUDY OF A 24-HOUR OBSERVATION PROTOCOL Menditto, V.G., et al, Ann Emerg Med 59(6):451, June 2012 6% of people on anticoagulation with a first negative CT had a bleed on repeat CT after 24 hours Lalalalalala I’m not listening.
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