Whole-body multislice computed tomography as the first line diagnostic tool in patients with multiple injuries: the focus on time

J Trauma. 2009 Mar;66(3):658-65. doi: 10.1097/TA.0b013e31817de3f4.

Abstract

Objective: Whole-body multislice helical computed tomography (MSCT) becomes increasingly important as a diagnostic tool in patients with multiple injuries. We describe time requirement of two different diagnostic approaches to multiple injuries one with whole-body-MSCT (MSCT Trauma-Protocol) as the sole radiologic procedure and one with conventional use of radiography, combined with abdominal ultrasound and organ focused CT (Conventional-Trauma-Protocol).

Methods: Observational study with retrospective analysis of time requirements for resuscitation, diagnostic workup and transfer to definitive treatment after changing from conventional to MSCT Trauma-Protocol. Group I: data from trauma patients imaged with whole-body MSCT. Group II: data of trauma patients investigated with conventional trauma protocol before the introduction of MSCT-Trauma-Protocol.

Results: The complete diagnostic workup in group I (n = 82) was finished after 23 minutes (17-33 minutes) [median; interquartile range (IQR)] and after 70 minutes (IQR, 56-85) in group II (n = 79). The definitive management plan based on a completed diagnostic workup was devised after 47 minutes (IQR, 37-59) in group I and after 82 minutes (IQR, 66-110) in group II.

Conclusion: A whole-body MSCT-based diagnostic approach to multiple injuries might shorten the time interval from arrival in the trauma emergency room until obtaining a final diagnosis and management plan in patients with multiple injuries and might, therefore, contribute to improvements in patient care.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Algorithms
  • Child
  • Efficiency, Organizational
  • Emergency Service, Hospital*
  • Equipment Design
  • Female
  • Germany
  • Humans
  • Injury Severity Score
  • Male
  • Middle Aged
  • Multiple Trauma / diagnostic imaging*
  • Multiple Trauma / surgery
  • Resuscitation / instrumentation
  • Retrospective Studies
  • Technology Assessment, Biomedical
  • Time and Motion Studies*
  • Tomography, Spiral Computed / instrumentation*
  • Triage
  • Whole Body Imaging / instrumentation*
  • Wounds, Nonpenetrating / diagnostic imaging*
  • Wounds, Nonpenetrating / surgery
  • Young Adult