Guidelines

Question 1

GCS of what
a) on initial assessment
b) 2hrs post
should have head CT within 1 hr?

Answer 1

a) <13

b) <15

Question 2

What other fx require head CT within 1 hr?

Answer 2

open/depressed skull #
basal skull # signs
seizure
focal neuro deficit 
1+ vomiting

Question 3

When should a pt with no risk factors but who is on anticoagulants have a head CT?

Answer 3

8 hrs

Question 4

Should someone with LOC/amnesia following injury have a head CT?

Answer 4

within 8hrs only if other risk factor:

> 65
bleeding/clotting disorder
dangerous MOI
30mins retrograde amnesia of events immediately before head injury

Question 5

When should someone with >30 mins retrograde amnesia have a head CT?

Answer 5

within 8hrs

Question 6

How should a large (>2cm) primary pneumothorax be managed?

Answer 6

aspirate with 16-18G cannula

Question 7

How should a symptomatic primary pneumothorax be managed?

Answer 7

aspirate with 16-18G cannula

Question 8

How should a small (<2cm) primary pneumothorax with no SOB be managed?

Answer 8

discharge + review in 2 weeks

Question 9

How should a symptomatic primary pneumothorax that has been aspirated but has ongoing breathlessness be managed?

Answer 9

chest drain + admit

Question 10

How should a secondary pneumothorax that is asymptomatic and <1cm be managed?

Answer 10

admit
high flow oxygen
observe 24 hrs

Question 11

How should a secondary pneumothorax that is 1.5cm and asymptomatic be managed?

Answer 11

aspirate

Question 12

How should a symptomatic secondary pneumothorax be managed?

Answer 12

chest drain + admit

Question 13

How should a 2.5cm secondary pneumothorax be managed?

Answer 13

chest drain + admit