Pretransfer imaging decisions in rural trauma cases.

In rural health settings, patients with trauma who initially are transported to a community hospital often require transfer to a designated trauma center. Rural hospitals typically are not equipped or properly staffed to treat severely injured patients. When trauma occurs, transport time longer than 60 minutes from an accident scene to a place of definitive care can have detrimental effects on the patient. This article discusses the differences in trauma care in rural and urban settings, explains situations in which the patient might not benefit from diagnostic imaging before transfer to an urban facility, and outlines ways to reduce unnecessary imaging of trauma patients at rural locations.