(145) Derivation of an emergency department-based clinical prediction tool to identify individuals at increased risk of chronic musculoskeletal pain development after motor vehicle collision

A 16-year-old male presented to the emergency department following a single-truck motor vehicle collision. The patient was the driver of an older model pickup truck that he lost control of while driving and went off of the road. He was restrained with a lap belt only, given the age of the vehicle. His only complaint at the presenting hospital was left-sided neck pain and hoarseness.

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Straining the Strain Diagnosis

The Cognitive Autopsy ◽

10.1093/med/9780190088743.003.0041 ◽

2020 ◽

pp. 263-270

Author(s):

Pat Croskerry

Keyword(s):

Emergency Department ◽

Neck Pain ◽

Motor Vehicle ◽

Implicit Bias ◽

Correct Diagnosis ◽

Motor Vehicle Collision ◽

Plain Radiographs ◽

Vehicle Collision ◽

Bony Injury

In this case, a woman in her late 30s was brought to the emergency department (ED) following a motor vehicle collision. She was a passenger in a car that was T-boned on the passenger side. Her principal complaint was neck pain. After plain radiographs showed no bony injury, she was discharged with cervical strain. She presented again to the same ED on three further occasions before her correct diagnosis was made. Aspects of implicit bias are highlighted in her care.

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Is an emergency department encounter for a motor vehicle collision truly a teachable moment?

Journal of Trauma and Acute Care Surgery ◽

10.1097/ta.0b013e31826b0161 ◽

2012 ◽

Vol 73 ◽

pp. S258-S261 ◽

Cited By ~ 5

Author(s):

Michael A. Gittelman ◽

Wendy J. Pomerantz ◽

Mona Ho ◽

Richard Hornung ◽

Nicole McClanahan

Keyword(s):

Emergency Department ◽

Motor Vehicle ◽

Motor Vehicle Collision ◽

Teachable Moment ◽

Vehicle Collision

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Risk of motor vehicle collisions after methadone use

eLife ◽

10.7554/elife.63954 ◽

2021 ◽

Vol 10 ◽

Author(s):

Ya-Hui Yang ◽

Pei-Shan Ho ◽

Trong-Neng Wu ◽

Peng-Wei Wang ◽

Chun-Hung Richard Lin ◽

...

Keyword(s):

Motor Vehicle ◽

Methadone Maintenance ◽

Adult Population ◽

Incidence Rates ◽

Motor Vehicle Collision ◽

Motor Vehicle Collisions ◽

Vehicle Collisions ◽

Vehicle Collision ◽

Increased Risk ◽

First 90 Days

Methadone maintenance treatment (MMT) can alleviate opioid dependence. However, MMT possibly increases the risk of motor vehicle collisions. The current study investigated preliminary estimation of motor vehicle collision incidence rates. Furthermore, in this population-based retrospective cohort study with frequency-matched controls, opiate adults receiving MMT (cases) and those not receiving MMT (controls) were identified at a 1:2 ratio by linking data from several nationwide administrative registry databases. From 2009 to 2016, the crude incidence rate of motor vehicle collisions was the lowest in the general adult population, followed by that in opiate adults, and it was the highest in adults receiving MMT. The incidence rates of motor vehicle collisions were significantly higher in opiate users receiving MMT than in those not receiving MMT. Kaplan–Meier curves of the incidence of motor vehicle collisions differed significantly between groups, with a significant increased risk during the first 90 days of follow-up. In conclusion, drivers receiving MMT have higher motor vehicle collision risk than those not receiving MMT in opiate users, and it is worthy of noticing road safety in such drivers, particularly during the first 90 days of MMT.

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73-year-old Female with Syncope and Motor Vehicle Collision

Clinical Practice and Cases in Emergency Medicine ◽

10.5811/cpcem.2021.7.53384 ◽

2021 ◽

Vol 5 (4) ◽

pp. 369-376

Author(s):

Kevin Flanagan ◽

Zachary Dezman ◽

Karl Dachroeden ◽

Laura Bontempo

Keyword(s):

Emergency Department ◽

Differential Diagnosis ◽

Motor Vehicle ◽

Motor Vehicle Collision ◽

Initial Assessment ◽

Case Presentation ◽

Traumatic Injuries ◽

Vehicle Collision ◽

Attending Physician ◽

Suspected Diagnosis

Introduction: Patients with traumatic injuries can be difficult to assess, and their evaluation often evolves in the emergency department (ED). We describe how an ED attending physician member developed a differential diagnosis for this presentation, arrived at a suspected diagnosis, and what test he proposed to prove his hypothesis. Case Presentation: This clinicopathological case presentation details the initial assessment and management of a 73-year-old female who presented to the ED following a motor vehicle collision precipitated by a syncopal episode. Conclusion: The final surprising diagnosis is then revealed.

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Opioids and the Risk of Motor Vehicle Collision: A Systematic Review

Journal of Pharmacy Technology ◽

10.1177/87551225211059926 ◽

2021 ◽

pp. 875512252110599

Author(s):

Silvia J. Leon ◽

Aaron Trachtenberg ◽

Derek Briscoe ◽

Maira Ahmed ◽

Ingrid Hougen ◽

...

Keyword(s):

Systematic Review ◽

Dose Response ◽

Motor Vehicle ◽

Motor Vehicle Collision ◽

Prescription Opioid ◽

Response Relationship ◽

Dose Response Relationship ◽

Opioid Prescription ◽

Vehicle Collision ◽

Increased Risk

Background: Opioid analgesics are among the most commonly prescribed medications, but questions remain regarding their impact on the day-to-day functioning of patients including driving. We set out to perform a systematic review on the risk of motor vehicle collision (MVC) associated with prescription opioid exposure. Method: We searched Medline, PubMed, EMBASE, Scopus, and TRID from January 1990 to August 31, 2021 for primary studies assessing prescribed opioid use and MVCs. Results: We identified 14 observational studies that met inclusion criteria. Among those, 8 studies found an increased risk of MVC among those participants who had a concomitant opioid prescription at the time of the MVC and 3 found no significant increase of culpability of fatal MVC. The 3 studies that evaluated the presence of a dose-response relationship between the dose of opioids taken and the effects on MVC risk reported the existence of a dose-response relationship. Due to the heterogeneity of the different studies, a quantitative meta-analysis to sum evidence was deemed unfeasible. Our review supports increasing evidence on the association between motor vehicle collisions and prescribed opioids. This research would guide policies regarding driving legislation worldwide. Conclusion: Our review indicates that opioid prescriptions are likely associated with an increased risk of MVCs. Further studies are warranted to strengthen this finding, and investigate additional factors such as individual opioid medications, opioid doses and dose adjustments, and opioid tolerance for their effect on MVC risk.

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Just the facts: Hypertonic saline is just as good as (and probably better than) mannitol

CJEM ◽

10.1017/cem.2019.455 ◽

2020 ◽

Vol 22 (2) ◽

pp. 152-154 ◽

Cited By ~ 1

Author(s):

Laurel Murphy

Keyword(s):

Emergency Department ◽

Medical History ◽

Hypertonic Saline ◽

Motor Vehicle ◽

Motor Vehicle Collision ◽

Past Medical History ◽

Significant Past Medical History ◽

Vehicle Collision ◽

Level Of Consciousness ◽

Better Than

A 27-year-old female is brought to the emergency department (ED) by ambulance following a motor vehicle collision at highway speed. She was the belted driver. She has no significant past medical history and is on no medications. Following a prolonged extrication, she is intubated due to decreased level of consciousness before transport.

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