Trauma surgeon utilization of computerized tomography scanning: Room for improvement?

We aimed to evaluate computerized tomography (CT) utilization and yield rates for trauma team activations (TTA).

A retrospective review of all TTAs was conducted over nine months. TTAs consisted of two levels--trauma alert (TAL) and trauma response (TR). Yields of CT for significant findings (SF) for four CT types (brain, cervical, chest, abdomen/pelvis) were recorded.

647 patients were included. There was no difference in the utilization rates of CTs except for brain CTs (TAL, 98% vs TR, 94%, p = 0.008). There was no difference in the yield rates except for cervical spine CTs (TAL, 8% vs TR, 4%, p = 0.03). Over 80% received a pan scan regardless of TTA level; 63% who had any CT had no SF. The median ratio of scans with SF to the total number of scans per patient was 0.

Regardless of activation level, CT seems to be over utilized. More selective use of CT should be evaluated.