• Avoid diagnostic momentum from the prehospital setting and always perform your own cervical spine evaluation.
• Patients at risk for cervical spine injuries have a high-impact mechanism (diving, motorized vehicles, surfing, etc.) and/or those who present to the ED with an abnormal physical exam (altered mental status, neurologic deficits).
• The risk of delayed ICH in patients on anticoagulants is exceedingly low.
• Decision to observe or repeat head CT should be individualized per patient presentation.
• Always discuss risks of delayed ICH with patients and their families prior to discharge.
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