Episode 923: Blunt Cerebrovascular Injury

Episode 923: Blunt Cerebrovascular Injury

Contributor: Travis Barlock MD

Educational Pearls:

  • Assessment of head and neck vascular injury due to blunt trauma

    • Symptomatic patients require screening head and neck CT angiography

  • EAST guidelines include the following criteria for a screening CT angiography in blunt head trauma:

    • Unexplained neurological deficits

    • Arterial nosebleed

    • GCS < 6

    • Petrous bone fracture

    • Cervical spine fracture

    • Any size fracture through the transverse foramen

    • LeFort fractures type II or type III

  • EAST guidelines include a grading scale for vascular injury:

    • Grade I: Luminal irregularity or dissection with <25% luminal narrowing

    • Grade II: Dissection or intramural hematoma with >25% luminal narrowing, intraluminal thrombus, or raised intimal flap

    • Grade III: Pseudoaneurysm

    • Grade IV: Occlusion

    • Grade V: Transection with free extravasation

References

  1. Bensch FV, Varjonen EA, Pyhältö TT, Koskinen SK. Augmenting Denver criteria yields increased BCVI detection, with screening showing markedly increased risk for subsequent ischemic stroke. Emerg Radiol. 2019;26(4):365-372. doi:10.1007/s10140-019-01677-0

  2. Biffl WL, Moore EE, Offner PJ, et al. Optimizing screening for blunt cerebrovascular injuries. Am J Surg. 1999;178(6):517-522. doi:10.1016/s0002-9610(99)00245-7

  3. Kim DY, Biffl W, Bokhari F, et al. Evaluation and management of blunt cerebrovascular injury: A practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2020;88(6):875-887. doi:10.1097/TA.0000000000002668

Summarized & Edited by Jorge Chalit, OMS3

Donate: https://emergencymedicalminute.org/donate/

Episoder(1149)

Episode 901: Underdosing in Status Epilepticus

Episode 901: Underdosing in Status Epilepticus

Contributor: Aaron Lessen MD Educational Pearls: Lorazepam (Ativan) is dosed at 0.1 mg/kg up to a maximum of 4 mg in status epilepticus Some ED protocols only give 2 mg initially The maximum r...

29 Apr 20242min

Episode 900: Ketamine Dosing

Episode 900: Ketamine Dosing

Contributor: Travis Barlock MD Educational Pearls: Ketamine is an NMDA receptor antagonist with a wide variety of uses in the emergency department. To dose ketamine remember the numbers 0.3, 1, and 3....

22 Apr 20242min

Episode 899: Thrombolytic Contraindications

Episode 899: Thrombolytic Contraindications

Contributor: Travis Barlock MD Educational Pearls: Thrombolytic therapy (tPA or TNK) is often used in the ED for strokes Use of anticoagulants with INR > 1.7 or  PT >15 Warfarin will reliably i...

15 Apr 20243min

Episode 898: Takotsubo Cardiomyopathy

Episode 898: Takotsubo Cardiomyopathy

Contributor: Ricky Dhaliwal, MD Educational Pearls: Takotsubo cardiomyopathy, also known as "broken heart syndrome," is a temporary heart condition that can mimic the symptoms of a heart attack, inc...

10 Apr 20243min

Episode 897: Adrenal Crisis

Episode 897: Adrenal Crisis

Contributor: Ricky Dhaliwal MD Educational Pearls: Primary adrenal insufficiency (most common risk factor for adrenal crises) An autoimmune condition commonly known as Addison's Disease Defects...

1 Apr 20244min

Podcast 896: Cancer-Related Emergencies

Podcast 896: Cancer-Related Emergencies

Contributor: Travis Barlock, MD Educational Pearls: Cancer-related emergencies can be sorted into a few buckets: Infection Cancer itself and the treatments (chemotherapy/radiation) can be immunos...

25 Mar 20242min

Episode 895: Indications for Exogenous Albumin

Episode 895: Indications for Exogenous Albumin

Contributor: Travis Barlock MD Educational Pearls: There are three indications for IV albumin in the ED Spontaneous bacterial peritonitis (SBP) Patients with SBP develop renal failure from volu...

18 Mar 20242min

Episode 894: DKA and HHS

Episode 894: DKA and HHS

Contributor: Ricky Dhaliwal, MD Educational Pearls: What are DKA and HHS? DKA (Diabetic Ketoacidosis) and HHS (Hyperosmolar Hyperglycemic State) are both acute hyperglycemic states. DKA More com...

11 Mar 20247min

Populært innen Vitenskap

fastlegen
tingenes-tilstand
rss-nysgjerrige-norge
rekommandert
liberal-halvtime
forskningno
sinnsyn
rss-rekommandert
fjellsportpodden
smart-forklart
vett-og-vitenskap-med-gaute-einevoll
jss
villmarksliv
hva-er-greia-med
rss-overskuddsliv
rss-radium
dekodet-2
rss-inn-til-kjernen-med-sunniva-rose
tidlose-historier
aldring-og-helse-podden