An evidence based blunt trauma protocol

Area of Science:

• Emergency Medicine
• Radiology
• Trauma Surgery

Background:

• Computed tomography (CT) is increasingly used for trauma patient evaluation.
• A need exists for standardized protocols in high-energy trauma assessment.
• Optimizing radiological workups is crucial for efficient patient care.

Purpose of the Study:

• To evaluate the clinical feasibility of a novel diagnostic protocol for adult blunt high-energy trauma patients.
• To assess the protocol's impact on the utilization of conventional radiography (CR) and CT scans.
• To determine the safety and efficiency of the new protocol in a prospective study.

Main Methods:

• Developed an evidence-based flowchart for CR, sonography, and CT appropriateness.
• Prospectively enrolled 81 consecutive adult blunt high-energy trauma patients.
• Monitored protocol adherence, scan types, procedure times, adverse events, and missed injuries.

Main Results:

• Achieved 99% adherence to the protocol for CT utilization.
• CT scans were performed in 98% of patients, with high rates for cervical spine (96%) and thoracoabdominal (89%).
• Identified potential for omitting CT in 30 patients; CR was incorrectly omitted or performed in 38% of cases. No major adverse events or missed injuries were reported.

Conclusions:

• The new diagnostic protocol is feasible and safe for evaluating adult blunt high-energy trauma.
• Implementation may reduce unnecessary radiological investigations, particularly CT scans.
• The protocol shows promise for optimizing trauma patient radiological workups.