List Archives

Wed Jul 8 14:30:18 BST 2009

Colleagues,

82 year old woman on Warfarin (Coumadin) 5.0 mg per day trips on a rug, falls striking her forehead. She is brought to the Emergency Department by her daughter who she lives with. She is amnestic for the event and has a superficial forehead abrasion. Her physical examination is normal, her head CT scan is also normal, and her INR is 3.0. Should she have been made a trauma patient? Do you admit her for observation? Do you schedule a repeat head CT scan and if so, how many hours later?

75 year old man on Clopidogrel (Plavix) 75 mg daily for recent placement of a drug eluding coronary stent is in a moderate speed MVC and complains of left shoulder and arm pain. He has an A-C separation but an otherwise negative workup including head CT and torso CT and EKG. Should he be admitted for observation? Should he have a repeat head CT scan and if so, when?

Mike Sise
San Diego

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Elederly falls on Coumadin or Plavix