INTRODUCTION: Trauma remains a major cause of mortality and morbidity, particularly among young adults. A major trauma (whole-body) CT protocol based upon mechanism of injury was investigated in a busy emergency department. METHODS: Trauma patients presenting in two 3-month periods before and after the introduction of a major trauma CT protocol were identified. The mechanism of injury, Injury Severity Score, radiological imaging performed and injuries detected were recorded. RESULTS: More eligible patients received major trauma CT scanning post-protocol than pre-protocol (87/114 (76%) vs 44/94 (47%)). There were no adverse effects attributable to major trauma CT. Seventeen injuries were detected post-protocol that would not have been detected had imaging been conducted based on clinical suspicion rather than mechanism of injury. In three cases an immediate intervention was required. CONCLUSION: Our major trauma CT protocol, based on mechanism of injury, resulted in substantial changes in clinical management in a small number of patients without any increase in adverse events. However, it is not a substitute for clinical acumen in the initial assessment of trauma patients.
INTRODUCTION:Trauma remains a major cause of mortality and morbidity, particularly among young adults. A major trauma (whole-body) CT protocol based upon mechanism of injury was investigated in a busy emergency department. METHODS:Traumapatients presenting in two 3-month periods before and after the introduction of a major trauma CT protocol were identified. The mechanism of injury, Injury Severity Score, radiological imaging performed and injuries detected were recorded. RESULTS: More eligible patients received major trauma CT scanning post-protocol than pre-protocol (87/114 (76%) vs 44/94 (47%)). There were no adverse effects attributable to major trauma CT. Seventeen injuries were detected post-protocol that would not have been detected had imaging been conducted based on clinical suspicion rather than mechanism of injury. In three cases an immediate intervention was required. CONCLUSION: Our major trauma CT protocol, based on mechanism of injury, resulted in substantial changes in clinical management in a small number of patients without any increase in adverse events. However, it is not a substitute for clinical acumen in the initial assessment of traumapatients.
Authors: Martin Hutter; Alexander Woltmann; Christian Hierholzer; Christian Gärtner; Volker Bühren; Dirk Stengel Journal: Scand J Trauma Resusc Emerg Med Date: 2011-12-09 Impact factor: 2.953
Authors: Joanne C Sierink; Teun Peter Saltzherr; Ludo F M Beenen; Jan S K Luitse; Markus W Hollmann; Johannes B Reitsma; Michael J R Edwards; Joachim Hohmann; Benn J A Beuker; Peter Patka; James W Suliburk; Marcel G W Dijkgraaf; J Carel Goslings Journal: BMC Emerg Med Date: 2012-03-30
Authors: Carlos Ordoñez; Carlos García; Michael W Parra; Edison Angamarca; Mónica Guzmán-Rodríguez; Claudia P Orlas; Juan Pablo Herrera-Escobar; Erika Rincón; Juan José Meléndez; Jose Julián Serna; Natalia Padilla; Ana Milena Del Valle; Alberto F García; Alfonso Holguín Journal: Colomb Med (Cali) Date: 2020-03-30