Keywords:
Trauma, Quality assurance, Education and training, Outcomes analysis, Audit and standards, CT, Emergency
Authors:
S. Sinha, B. Owen, S. Beattie, A. Kraus, L. Dykes; Bangor/UK
DOI:
10.1594/ecr2013/C-1636
Conclusion
Traditional free-text CT reports by consultant radiologists in our institution are insufficiently precise to generate a reliable ISS.
This impacts upon both research and audit:
- TARN may actually be auditing the precision of radiology reports,
rather than the quality of major trauma care in the UK
- Comparison of different countries' trauma systems and trauma literature,
which often utilises the ISS,
may reflect differences in custom and practice of radiology reporting
On a national,
European and international scale,
the impact of this effect may be substantial.
We recommend that,
alongside introduction of standardised trauma reporting formats (see below),
radiologists are familiar with injury scoring systems most commonly used in their country.
Standardised Trauma Reporting Template:
HEAD & MSK
CT Head:
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C-Spine:
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T & L Spine:
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Pelvic Bones:
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CHEST
Vascular Injury
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Chest wall (ribs)
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Lungs
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Diaphragm
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Mediastinum
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Pleural Space
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Other Findings
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ABDOMEN & PELVIS
Free Gas
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Bowel/Mesentery
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Peritoneal Fluid
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Vascular Injury
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Spleen
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Liver
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Pancreato-biliary
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Renal/Adrenal
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Retroperitoneum
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Bladder
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Other findings
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Delayed imaging
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Rectal contrast
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An example of a pro-forma trauma report template that may aid radiologists in injury scoring.