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.
