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Updated: Apr 24, 2026
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
[The injured child--diagnostic work-up in the emergency room]
C Schöneberg1, B Schweiger, M Metzelder
1Klinik für Unfallchirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Deutschland, carsten.schoeneberg@uk-essen.de.
Insights
Diagnosing injured children in the ER requires a trauma team and careful use of CT scans to minimize radiation exposure and cancer risk. Algorithms guide differentiated CT use, prioritizing safety in critical cases.
Area of Science:
- Pediatric Emergency Medicine
- Medical Imaging
- Radiation Oncology
Background:
- Pediatric trauma diagnosis necessitates specialized interdisciplinary teams and facilities.
- Standard emergency room protocols for injured children are similar to adults.
- Ionizing radiation from diagnostic imaging poses a significant risk of malignancy in children.
Purpose of the Study:
- To outline best practices for diagnosing injured children in emergency settings.
- To emphasize the risks associated with radiation exposure in pediatric trauma imaging.
- To introduce algorithms for the judicious use of computed tomography (CT) scans.
Main Methods:
- Review of current pediatric trauma care guidelines.
- Analysis of radiation risks associated with diagnostic imaging modalities.
- Development of algorithmic approaches for differentiated CT utilization.
Main Results:
- Pediatric trauma care benefits from specialized trauma centers and interdisciplinary collaboration.
- Computed tomography (CT) scans contribute significantly to radiation exposure in pediatric trauma patients.
- Proposed algorithms aim to balance diagnostic necessity with radiation risk reduction.
Conclusions:
- Differentiated CT use is crucial for minimizing malignancy risk in pediatric trauma patients.
- Algorithms can guide appropriate CT utilization without compromising patient safety.
- Whole-body CT is justified in critically injured children for rapid assessment and treatment.
Abstract:
The diagnosis of an injured child in the emergency room requires interdisciplinary collaboration and should be performed in a level 1 or 2 trauma center, if possible. Here, the basic trauma team could be complemented with (pediatric) surgeons. In a pediatric trauma center, specially trained pediatric surgeons or trauma surgeons, anesthetists, and radiologists who are experienced in the treatment of children should be available. The initial emergency room treatment does not differ significantly from that of adults. Ionizing radiation is the greatest hazard for children in the diagnosis of trauma patients. The CT scan is responsible for most of the radiation. To reduce the risk of developing a malignancy, the most harmful consequence of radiation, differentiated use is necessary. This can be achieved by using the presented algorithms. However, the differentiated use of the CT should not result in additional risk to the child. If the child is in a critical condition and obviously has multiple life-threatening injuries, the use of a whole-body CT is justified, due to time saving and targeted therapy of the child.
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