Publications by authors named "Christopher Trigger"

10 Publications

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A randomized cohort study of the efficacy of PO magnesium in the treatment of acute concussions in adolescents.

Am J Emerg Med 2020 Jul 9. Epub 2020 Jul 9.

Department of Emergency Medicine, Spectrum Health, Lakeland, St Joseph, MI, United States of America.

Introduction/study Objective: Concussions are becoming a growing concern in society today with one out of every five adolescents being affected. This accounts for 1.6 to 3.8 million emergency department visits annually. The current standard of care involves an initial period of mental rest with symptomatic care and symptom-based return to daily activities/sports. High dose IV magnesium has been proven to be neuroprotective in severe TBI. We hypothesized that oral magnesium replacement following a concussion will decrease the overall symptomatic period allowing a quicker return to functional baseline.

Methods: We used a randomized cohort study involving patients aged 12-18 who presented within 48 h after a concussion. Our study design had a treatment arm including acetaminophen, ondansetron, and magnesium PO and a placebo arm of acetaminophen and ondansetron. We then utilized the Post- Concussion Severity Score (PCSS) to evaluate the extent of the patient's symptoms. This score was collected immediately prior to obtaining medications, 1 h, 48 h, and 120 h after starting the study. The study relied on outpatient follow up through phone conversations, and a Sports Medicine clinic locally.

Results: Our data shows that there was a statistically significant decrease in the PCSS at 48 h (p = 0.016) in the magnesium group relative to the placebo treatment arm. This study does imply that magnesium supplementation has potential benefit in treatment of concussions acutely.

Conclusion: Oral magnesium replacement decreases symptoms acutely following a concussion and should be provided with symptomatic management following a concussion in the emergency setting.
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http://dx.doi.org/10.1016/j.ajem.2020.05.010DOI Listing
July 2020

Ancillary Findings on CT Pulmonary Angiograms that are Negative for Pulmonary Embolism.

Spartan Med Res J 2020 Jan 30;4(2):11769. Epub 2020 Jan 30.

Sparrow Health System.

Context: One advantage of computed tomographic pulmonary angiograms (CTPA) is that they often show pathology in patients in whom pulmonary embolism (PE) has been excluded. In this investigation, we identified the ancillary findings on CTPAs that were negative for PE to obtain an impression of the type of findings shown.

Methods: This was a retrospective analysis of findings on CTPAs that were negative for PE obtained in nine emergency departments between January 2016 - February 2018. Ancillary findings were assessed by review of the radiographic reports.

Results: Ancillary findings were identified in N=338 (40.9%) of 825 patients with CTPAs that were negative for PE. Most ancillary findings, 254 (75.1%) of 338 were pulmonary or pleural abnormalities. Liver, gall bladder, kidney, or pancreatic abnormalities were shown in 26 (7.7%) cases, and abnormalities of the heart or great vessels were shown in 23 (6.8%) of cases. Abnormalities of the esophagus or intestine were shown in 12 (3.6%), abnormalities of the thyroid in 10 (3.0%) and abnormalities of bone or soft tissue lesions were shown in three (0.9%) cases. Inferential statistical procedures demonstrated that the occurrence of ancillary findings in patients with negative CTPAs was proportionately greater in patients who were 50 years and older (p < 0.001), although not between genders (p = 0.145).

Conclusions: Ancillary findings on CTPAs that were negative for PE were frequently reported. Future studies might focus of the extent to which ancillary findings on CTPA assisted physicians in management of the patient.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746057PMC
January 2020

Post-operative Appendix Specimen Retention Presenting as Small Bowel Obstruction.

Clin Pract Cases Emerg Med 2017 Nov 3;1(4):287-290. Epub 2017 Oct 3.

Lakeland Health, Department of Emergency Medicine, Saint Joseph, Michigan.

One rare complication of appendectomy is a retained appendicolith, which can become a focal point for infection presenting hours to years after surgery. We present a case in which a 50-year-old male presented to the emergency department with a small bowel obstruction one week post appendectomy. A diagnostic laparoscopy was performed, and a necrotic appendiceal specimen containing a staple line across the base as well as an appendicolith was removed. It is crucial to include rare surgical complications in our differentials, alongside the more common pathologies when approaching and treating patients with abdominal pain.
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http://dx.doi.org/10.5811/cpcem.2017.5.34078DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5965195PMC
November 2017

Pediatric Oral Commissure Burn.

Clin Pract Cases Emerg Med 2017 Mar 18;1(1):59-60. Epub 2017 Jan 18.

Michigan State University College of Osteopathic Medicine and Lakeland Health, Department of Emergency Medicine, St. Joseph, Michigan.

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http://dx.doi.org/10.5811/cpcem.2016.10.32247DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5965444PMC
March 2017

Purpuric skin eruption in an illicit drug user: Levamisole-induced vasculitis.

Am J Emerg Med 2016 Jul 1;34(7):1321.e5-6. Epub 2015 Dec 1.

Lakeland Health Emergency Medicine Residency Program, Lakeland Health, Saint Joseph, MI 49085.

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http://dx.doi.org/10.1016/j.ajem.2015.11.055DOI Listing
July 2016

Spontaneous Adrenal Hemorrhage in Pregnancy Presenting as a Pulmonary Embolism.

J Emerg Med 2016 Feb 4;50(2):e97-8. Epub 2015 Oct 4.

Lakeland Health Department of Medical Education, Saint Joseph, Michigan.

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http://dx.doi.org/10.1016/j.jemermed.2015.08.014DOI Listing
February 2016

Thoracic outlet syndrome with secondary Paget Schröetter Syndrome: a rare case of effort-induced thrombosis of the upper extremity.

West J Emerg Med 2014 Jul;15(4):364-5

Lakeland Regional Medical Center, Department of Emergency Medicine, Saint Joseph, Michigan.

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http://dx.doi.org/10.5811/westjem.2014.4.21521DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4100831PMC
July 2014

Lemierre's Syndrome.

West J Emerg Med 2014 Mar;15(2):125-6

Lakeland Regional Medical Center, Department of Emergency Medicine, St Joseph, Michigan.

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http://dx.doi.org/10.5811/westjem.2013.12.20418DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966442PMC
March 2014

High-pressure injection injury with molten aluminum.

West J Emerg Med 2014 Mar;15(2):120-1

Lakeland Regional Medical Center, Department of Emergency Medicine, St Joseph, Michigan.

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http://dx.doi.org/10.5811/westjem.2013.10.19443DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966439PMC
March 2014

Irritant contact dermatitis from jet fuel.

West J Emerg Med 2009 Aug;10(3):203

University of Illinois at Chicago, Department of Emergency Medicine.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729226PMC
August 2009