Removing barriers to early CT scanning in emergency and inpatient radiology

Over the last 5 years, several key trends have emerged which challenge the established paradigm of inpatient computed tomography (CT) services. Many widespread practices seem intuitive and have become dogmatic; these include pre-hydration for renal injury, holding medications which predispose to metabolic acidosis, steroid administration for allergies, oral contrast administration, and fasting. The efficacy and cost-benefit of all of these measures have been challenged by recent publications. A common theme has emerged, delaying inpatient CT scans worsens patient outcomes and increases cost.