Related Experiment Video
Updated: Jun 12, 2026
Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
Major trauma CT scanning: the experience of a regional trauma centre in the UK
Christopher M Smith1, Louise Woolrich-Burt, Richard Wellings
1Clinical Sciences Research Institute (University of Warwick), University Hospitals Coventry and Warwickshire, Coventry, UK. cms029@doctors.org.uk
Insights
A new major trauma CT protocol based on injury mechanism increased scanning rates and detected more injuries without adverse effects. This protocol aids clinical management but does not replace physician expertise.
Area of Science:
- Emergency Medicine
- Radiology
- Trauma Surgery
Background:
- Trauma is a leading cause of death and disability, especially in young adults.
- A major trauma (whole-body) CT protocol was implemented in an emergency department.
- The protocol was based on the mechanism of injury.
Purpose of the Study:
- To evaluate the impact of a major trauma CT protocol based on mechanism of injury.
- To compare CT scanning rates and injury detection before and after protocol implementation.
- To assess the safety and clinical utility of the new protocol.
Main Methods:
- A retrospective study comparing two 3-month periods before and after protocol introduction.
- Patient data included mechanism of injury, Injury Severity Score, and imaging results.
- Injuries detected by CT were compared to those expected based on clinical suspicion.
Main Results:
- Major trauma CT scans increased significantly post-protocol (76% vs 47%).
- Seventeen injuries were detected that might have been missed with clinical suspicion alone.
- No adverse events were linked to the major trauma CT protocol.
Conclusions:
- The mechanism of injury-based CT protocol improved patient management in a subset of cases.
- The protocol led to substantial clinical changes without increasing adverse events.
- Clinical judgment remains essential for initial trauma patient assessment.
Introduction:
Trauma remains a major cause of mortality and morbidity, particularly among young adults. A major trauma (whole-body) CT protocol based upon mechanism of injury was investigated in a busy emergency department.
Methods:
Trauma patients presenting in two 3-month periods before and after the introduction of a major trauma CT protocol were identified. The mechanism of injury, Injury Severity Score, radiological imaging performed and injuries detected were recorded.
Results:
More eligible patients received major trauma CT scanning post-protocol than pre-protocol (87/114 (76%) vs 44/94 (47%)). There were no adverse effects attributable to major trauma CT. Seventeen injuries were detected post-protocol that would not have been detected had imaging been conducted based on clinical suspicion rather than mechanism of injury. In three cases an immediate intervention was required.
Conclusion:
Our major trauma CT protocol, based on mechanism of injury, resulted in substantial changes in clinical management in a small number of patients without any increase in adverse events. However, it is not a substitute for clinical acumen in the initial assessment of trauma patients.
Related Concept Videos
01:10Computed Tomography
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...
01:27Imaging Studies III: Computed Tomography
01:28Imaging Studies for Cardiovascular System V: CT
01:28Traumatic Brain Injury l: Introduction
01:14Imaging Studies I: CT and MRI
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...
01:30Radiological Investigation I: X-ray and CT