Minor Blunt Thoracic Trauma in the Emergency Department: Sensitivity and Specificity of Chest Ultralow-Dose Computed Tomography Compared With Conventional Radiography

Methodology: 2/5 Usefulness: 2.5/5 Macri F, Greffier J, Khasanova E, Claret PG, Bastide S, Larbi A, Bobbia X, Pereira FR, de la Coussaye JE, Beregi JP. Ann Emerg Med. 2019 Jun;73(6):665-670.  Question and Methods: This 160-patient pilot study prospectively compared ultra-low dose CT chest and CXR to routine CT chest in minor blunt thoracic trauma patients. Findings: ULD-CT chest was 100% sensitive and specific, […]

Diagnosis of Elevated Intracranial Pressure in Critically Ill Patients

In the Emergency Department (ED) and Intensive Care Unit (ICU), we often encounter patients with brain injury. This includes patients with traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), and intracerebral hemorrhage (ICH), among others [1]. In the ED and ICU, our management of these patients is namely focused upon the prevention of secondary brain injury, and this often involves avoidance […]

A Bloody Mess: an Update on UGIB Management in the ED

Acute upper gastrointestinal bleeding (UGIB) is an all-too-frequent presentation that can scare the pants off of even the most seasoned Emergency Physician.  Severity of presentation can vary greatly, from simple bleeds related to gastritis to exsanguinating variceal bleeds. Common etiologies of UGIB, with frequency in parentheses, include (1): Peptic ulcer disease (31-67%) Gastritis or duodenitis (7-31%) Erosive esophagitis (4-24%) Variceal […]

Abdominal Stab Wounds: A Decision Algorithm

If you work at a trauma center, then you’re bound to see your fair share of abdominal stab wounds. Though civilian penetrating trauma has declined over recent decades and is less common than blunt trauma, penetrating trauma represents ~10% of all trauma evaluations in the U.S. and of those, ~50% are caused by stab wounds. In  2018, the Western Trauma […]