Acute myocardial infarction presenting as subarachnoid hemorrhage

The Canadian head CT rule; a hospital audit

“…It standardizes the emergency management of patients with mild traumatic brain injury with improved utilization of resources.This study showed that there is an overuse of CT scans for minor head injury patients. Employment of a simple tool such as the Canadian head CT rule which can be taught to medical officers in an emergency department setting could reduce the use of CT scans by 63%, a figure demonstrated in several other centers (8,9,11). With an 87.5% negative predictive value the rule can safely be used to inform the decision on whether or not to perform a CT scan.…”

“…Dangerous mechanisms as outlined in the derivation of the Canadian head Ct rule are a pedestrian struck by a vehicle, vehicle occupant ejected and fall from a height of more than three feet. Positive CT scan findings as per the Canadian head CT rule were defined as clinically important injury found on CT scan which ordinarily would require admission and neurological follow up (8). All brain injuries were ruled significant except the following: solitary contusions less than 5mm, localized subarachnoid bleeds of less than 4mm, isolated pneumocephalus and closed depressed fractures not through the inner table (12).The data collected was cross tabulated to show how many of the patients identified had CT scans done.…”