Trauma Imaging Guideline

Imaging of Adult Trauma Patients on Admission
Trauma Scan:
                  CT Head
                  CT Spine (C,T,L)
                  CT Chest/Abd/Pelvis

Adjuncts:
                  CTA Head/Neck:  see BCVI protocol
                  CTA Extremity:  consider if ABI abnormal
                  CTA Face:  for obvious facial deformities
                  CT Cysto:  gross hematuria
                  CT Abd w/ Rectal contrast:  if low pelvis injury concerning.

Indications to consider for Trauma Scan:
·       Blunt Trauma Reds
·       High-energy Mechanism:  MVCs, Pedestrian Struck, BCC, ATVC, Multiple blow Assault
·       Elderly (>65 years) Fall from Standing

References:
http://www.ucsfcme.com/2010/slides/MAN10002/23%20Spain.pdf
Dwyer et al.  Radiographic assessment of ground-level falls in elderly patients.  Is the “PAN-SCAN” overdoing it?  Surgery. 2013 Oct; 154(4): 816-20.
Wurmb et al.  Whole-body multislice computed tomography (MSCT) improves trauma care in patients requiring surgery after multiple trauma.  Emerg Med J. 2011 Apr; 28(4):300-4.                 
Wurmb et al.  Polytrauma management in a period of change:  time analysis of new strategies for emergency room treatment.  Unfallchirurg. 2009 Apr; 112(4):390-9
Weninger et al.  Emergency room management of patients with blunt major trauma:  evaluation of the multislice computed tomography protocol exemplified by an urban center.  J Trauma. 2007 Mar; 62(3); 584-91.
Do we really need CT in primary evaluation of blunt chest trauma in patients with “normal” CXR?  J Trauma 2001; 51:1173-6
Reformatted visceral protocol HCT vs conventional radiographs of T and L spine in blunt trauma patients.  J Trauma 2003; 55:665-9
Salim et al.  Whole Body Imaging in Blunt Multisystem Trauma Patients without Obvious Signs of Injury.  Arch Surg 2006; 141: 468-475.