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Paediatric head injury - to scan or not to scan?

This week's teaching we visit the rationale of CT brain imaging of children after head trauma.  Dr Cynthia Lim goes through the 3 main rules : CATCH, CHALICE and PECARN and outlines the fact that in most children with isolated vomiting and normal GCS, the rate of clinically significant head injury is miniscule.  In fact, even with high risk features such as GCS<14, altered mental state or palpable skull fracture (PECARN) who were scanned, the rate was 4-5%.  The yield of injuries requiring intervention post CTB remains lower still.  One should take into account factors such as age, parental preference, clinical progress and availability of neurosurgical backup when considering a CTB... not the very least, the 2-year risk of leukemia of 1/2000.

Click here for talk.


UCSF High Risk Emergency Medicine Conference 2012

Dr Cynthia Lim recently attended an EM conference in San Francisco in May this year and brought us an enlightening talk of useful tricks at Registrar teaching (courtesy of Dr Michelle Lin, A/Prof San Francisco GH).  These range from:

how to reduce a dislocated hip in style, secure an avulsed tooth, reduce a prolapsed rectum to (what in the world is) the reverse sugar tong splint for fractured distal radius.

Click here for talk for those who missed it.

Also, here is a great series of titbits on how to manage various trauma scenarios eg penetrating neck trauma, pregnancy and massive haemorrhage resuscitation.



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