Traumatic injuries: organization and ergonomics of imaging in the emergency environment

Management of trauma patients relies on a simple but obvious concept: Time is life! This is a challenge to the emergency radiologist in his evaluation of the radiological admission survey of severe trauma patients, since the latter need a quick and thorough survey of craniocerebral, cervical, thoracic, abdominal, and limb lesions. This article reviews the architectural design and the management strategies required to fulfill this purpose. Whereas plain films and ultrasonography have precise but limited indications, multislice spiral CT (MSCT) shows an increasingly preponderant role in the imaging evaluation of trauma patients, as demonstrated through three examples (aortic, spine, and craniocerebral trauma). Multislice CT affords a comprehensive assessment of trauma patients' injuries and allows for their categorization according to the severity of traumatic lesions. With respect to the MSCT data volume, the emergency radiologists have to modify the strategies in their examination reading and result transmission, with a growing role attributed to two- and three-dimensional reconstructions. The emergency radiologist's role is thus of prime importance in the management of trauma patients, and this all the more so since development of interventional radiology affords therapeutic procedures alternative to surgery. Trauma radiology and emergency radiology on the whole will assert themselves as consistent and thorough areas of subspecialization.