Computed tomography whole body imaging in multi-trauma: 7 years experience

Area of Science:

• Emergency Medicine
• Radiology
• Trauma Surgery

Background:

• Multi-trauma patients require rapid and accurate diagnosis.
• Conventional radiography has limitations in detecting certain injuries.
• Computed tomography (CT) offers advanced imaging capabilities.

Purpose of the Study:

• To evaluate the impact of a new CT imaging protocol on multi-trauma patients.
• To assess changes in diagnostic yield, workload, and detection rates for specific injuries.
• To determine the effectiveness of CT in identifying cervical spine injuries and pneumothoraces.

Main Methods:

• A comprehensive helical CT protocol was implemented for hemodynamically stable multi-trauma patients.
• Patients underwent CT after initial triage and standard trauma radiographs.
• Prospective recording of diagnoses before and after CT was performed.

Main Results:

• CT identified numerous unsuspected injuries, including 19 cervical spine fractures and 36 pneumothoraces missed by initial radiography.
• The protocol demonstrated a wide range of significant injuries, including head, spine, thoracic, and abdominal trauma.
• Only 296 patients met criteria for the CT protocol over 7 years, indicating a small overall workload impact.

Conclusions:

• The multi-trauma CT protocol is effective in rapidly and accurately diagnosing significant injuries.
• It substantially improves the detection of cervical spine fractures and pneumothoraces compared to plain radiographs.
• The protocol has a minimal impact on overall hospital workload despite its diagnostic benefits.