Background/introduction
Trauma is the most common cause of death in patients under 40 years old[1].The Royal College of Radiologists (RCR) have issued standards and guidance for trauma radiology in severely injured patients (SIPs) [2]. Their recommendations include that “definitive imaging will most often be head-to-thigh contrast-induced multi-detector computed tomography (MDCT)” and “there may be indications for plain digital radiography, but these should never delay an MDCT if a decision has been taken early that this is the imaging modality of choice”[2]. Whole-body MDCT has been shown...
Description of activity and work performed
Objectives
1. What type of imaging isused to investigate trauma patients?
2. Are the scans indicated based on the presentation and clinical examination?
3. Are CTs being performed and reported within the recommended times frames?
4. How many of these patients have significant findings?
Method
Trauma patients who attended the emergency department between 20/07/2019 to 20/08/2019 were identified using CDN Radiology Information System (CRIS). Time of arrival, clinical information, scan type and time, time report verified and significant findings were recorded.
Method
Trauma patients who...
Conclusion and recommendations
Discussion
The majority of CT head and c-spine scans were considered indicated at our institution. Clear and consistent NICE guidance facilitate clinicians in deciding which patients require imaging.
In contrast, many of the body CTs (thorax/abdomen/pelvis) did not appear to be indicated. This is concerning considering that 39% of patients scanned are under the age of 65 potentially exposing this group to unnecessary radiation.
Most patients who fall into the SIPs category are transferred directly to a major trauma unit. CT appears to be overused...
Personal/organisational information
M. Al-Mahtot; Chertsey, Surrey/UK - nothing to disclose N. McCarville; Chertsey, Surrey/UK - nothing to disclose K. Luckyram; Chertsey, Surrey/UK - nothing to disclose A. Tighilt; Chertsey, Surrey/UK - nothing to disclose K. Tekle - Ashford and St Peter’s NHS Trust Surrey/UK - nothing to disclose E. Sharma - Ashford and St Peter’s NHS Trust Surrey/UK - nothing to disclose
References
1. Department of Health (2007).The Burden of Disease and Illness in the UK. London.[Available from: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_085152.pdf accessed 2nd October 2019].
2. The Royal College of Radiologists.Standards of practice and guidance for trauma radiology in severely injured patients (second edition). London: The Royal College of Radiologists. 2015
3. Huber-Wagner S, Lefering R, Qvick LM et al. Effect of whole-body CT during trauma resuscitation on survival: a retrospective, multicentre study. Lancet, 2009; 373: 1455-1461.
4. British Orthopaedic Association and British Society of Spine Surgeons. Standards for trauma...