EmDocs - April 26, 2021 - By Blake Davidson; Gena Cooper
Reviewed by: Andy Grock; Alex Koyfman; Brit Long
“Pitfalls and Pearls
- The Canadian Head CT Rule can help guide the decision to perform a head CT and is more sensitive than other clinical decision rules.
- The data for prophylactic antibiotic use in open skull fractures is poor. Know your hospital policy and discuss with neurosurgeon. Fractures such as frontal sinus fractures though, will often need antibiotics as they communicate with the other sinuses.
- Depressed skull fractures can be associated with obstructed venous sinuses requiring an emergent surgery for decompression.
- Basilar skull fracture signs can be missed initially as bruising may not have developed yet.
- Temporal bone fractures can be associated with multiple vessel and nerve injuries, so physical exam is extremely important”