List Archives

Wed May 6 01:36:51 BST 2009

I do not think it would be SAFE to stent this patient, nor coumadinize this 
 patient, nor heparinize this patient, nor CT this patient.   There is  NO 
good data to support any of these.  

I do think it would be SAFE to observe this patient, to operate on this  
patient, to give LMWH to this patient, to do an arteriogram on this  patient.  
 There is not good data to support any of these  options.  

k

In a message dated 5/5/2009 7:30:07 P.M. Central Standard Time,  
khumarhuse at yahoo.ca writes:

Clarification: not my pt, I was asked the question.

Yes,  am aware of high FP rates of imaging in blunt carotid injury, but  
took the results at face value. Given your comment on 'missecting'  hematoma 
and the fact taht the pt is asymptomatic, probably reimaging him w  angio is 
a better option. I just do not understand what LOW dose UFH treatment  is 
for. Agree about coumadin, but would it be SAFE to just sit on this pt  
without anticoagulating him fully if he has a true injury? and when to image  him 
again? same day, 24h later or wait till he develops suspicious signs?  
should one keep him in the hospital if he has been ok for 24hrs? and what if  the 
imaging shows HEMATOMA? wait and dont a/coagulate? what is  the incidence 
of pseudoaneurysm in true dissections? 
Wouldnt  stent a young pt (if he had true dissection) since long term 
results are  unknown.
thanks. KH

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Be CAREFUL Blunt CCA injury ina stable YOUNG pt