TY - JOUR T1 - Highlights from this issue JF - Emergency Medicine Journal JO - Emerg Med J SP - 657 LP - 657 DO - 10.1136/emermed-2020-210745 VL - 37 IS - 11 AU - Mary Dawood Y1 - 2020/11/01 UR - http://emj.bmj.com/content/37/11/657.abstract N2 - Every year approximately 1.4 million people attend the ED in the UK with a head injury. The National Institute for Health and Care Excellence (NICE) recommends routine CT imaging of all patients with mild head injury taking anticoagulants within 8 hours of injury. The risk of adverse outcomes following mild head injury when taking a DOAC is uncertain, nonetheless to many of us it often feels like an unnecessary investigation and over exposure of a patient who is clinically well and without symptoms. So you may be interested to read a paper by Fuller and colleagues from Sheffield, who conducted an observational cohort study with the aim of estimating the risk of adverse outcome after mild head injury in patients taking DOACs to guide emergency department management. The primary endpoint was adverse outcome within 30 days, comprising: neurosurgery, ICH, or death due to head injury. They found the risk of adverse outcomes following mild head injury in patients taking DOACs appears low. The authors suggest these findings would support shared patient-clinician decision making, rather than routine imaging following minor head injury while taking DOACs. This might be music to your ears and indeed the radiologist, especially in the middle of the night.Children are no … ER -