The Role of Whole-Body Computed Tomography in Severely Injured Patients Retrospective Single Center Cohort Study

2016 ◽  
Vol 6 (1) ◽  
pp. 18-22
Author(s):  
Hyun-Woo Sun ◽  
Suk-Kyung Hong ◽  
Min-Ae Keum ◽  
Jong-Kwan Baek ◽  
Jung-Sun Lee ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cohort Study ◽  
Whole Body ◽  
Severely Injured ◽  
Single Center ◽  
Severely Injured Patients ◽  
Whole Body Computed Tomography ◽  
Injured Patients

Whole-body computed tomography in severely injured patients

2018 ◽  
Vol 24 (1) ◽  
pp. 55-61 ◽  
Author(s):  
Stefan Huber-Wagner ◽  
Karl-Georg Kanz ◽  
Marc Hanschen ◽  
Martijn van Griensven ◽  
Peter Biberthaler ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Whole Body ◽  
Severely Injured ◽  
Severely Injured Patients ◽  
Whole Body Computed Tomography ◽  
Injured Patients

scholarly journals Outcomes of whole-body computed tomography in spinal cord-injured patients with sepsis

Spinal Cord ◽  
2014 ◽  
Vol 52 (7) ◽  
pp. 536-540 ◽  
Author(s):  
W A Ahmed ◽  
L L de Heredia ◽  
R J Hughes ◽  
M Belci ◽  
T M Meagher
Keyword(s):  
Computed Tomography ◽  
Spinal Cord ◽  
Whole Body ◽  
Whole Body Computed Tomography ◽  
Injured Patients ◽  
Spinal Cord Injured

Opportunities for improved trauma care of the elderly – A single center analysis of 2090 severely injured patients

2012 ◽  
Vol 55 (3) ◽  
pp. 660-666 ◽  
Author(s):  
Amadéa Schönenberger ◽  
Adrian T. Billeter ◽  
Burkhardt Seifert ◽  
Valentin Neuhaus ◽  
Otmar Trentz ◽  
...  
Keyword(s):  
Trauma Care ◽  
The Elderly ◽  
Severely Injured ◽  
Single Center ◽  
Severely Injured Patients ◽  
Injured Patients

scholarly journals Whole-body computed tomography is safe, effective and efficient in the severely injured hemodynamically unstable trauma patient

2020 ◽  
Author(s):  
Carlos Alberto Ordoñez ◽  
Michael Parra ◽  
Alfonso Holguín ◽  
Carlos Garcia ◽  
Monica Guzmán-Rodríguez ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Decision Making ◽  
Damage Control ◽  
Hemodynamic Instability ◽  
Whole Body ◽  
Trauma Patients ◽  
Severely Injured ◽  
Hemostatic Resuscitation ◽  
Whole Body Computed Tomography ◽  
Technological Advances

Trauma is a complex pathology that requires an experienced multidisciplinary team with an inherent quick decision-making capacity, given that a few minutes could represent a matter of life or death. These management decisions not only need to be quick but also accurate to be able to prioritize and to efficiently control the injuries that may be causing impending hemodynamic collapse. In essence, this is the cornerstone of the concept of Damage Control Trauma Care. With current technological advances, physicians have at their disposition multiple diagnostic imaging tools that can aid in this prompt decision-making algorithm. This manuscript aims to perform a literature review on this subject and to share the experience on the use of Whole Body Computed Tomography as a potentially safe, effective, and efficient diagnostic tool in cases of severely injured trauma patients regardless of their hemodynamic status. Our general recommendation is that, when feasible, perform a Whole-Body Computed Tomography without interrupting ongoing hemostatic resuscitation in cases of severely injured trauma patients with or without signs of hemodynamic instability. The use of this technology will aid in the decision-making of the best surgical approach for these patients without incurring any delay in definitive management and/or increasing significantly their radiation exposure.

scholarly journals Evaluation of the role of whole body computed tomography in the management of minor trauma patients.

2021 ◽  
Author(s):  
Gökhan AKSEL ◽  
İbrahim ALTUNOK ◽  
Şeref Kerem ÇORBACIOĞLU ◽  
Hatice Şeyma AKÇA ◽  
Öner BOZAN ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Whole Body ◽  
Trauma Patients ◽  
Minor Trauma ◽  
Whole Body Computed Tomography

Imaging Evaluation in the Early Management of Severely Injured Patients.

2021 ◽  
Author(s):  
Christopher Spering ◽  
Soehren Dirk Brauns ◽  
Bertil Bouillon ◽  
Mark-Tilmann Seitz ◽  
Katharina Jaeckle ◽  
...  
Keyword(s):  
Vascular Injury ◽  
Thoracic Trauma ◽  
Severely Injured ◽  
Severely Injured Patients ◽  
Initial Management ◽  
Trauma Centres ◽  
Therapeutic Consequences ◽  
Time Period ◽  
Injured Patients

Abstract Introduction: The plain film chest x-ray in supine position (CXR) during the initial management of severely injured patients has almost lost its clinical relevance, since it has been challenged by extended focused assessment with sonography in trauma (eFAST) in early trauma management, due to its superiority in detecting a pneumo-/hematothorax. One of the last diagnostic fields in such setting of CXR is the mediastinal vascular injury. These injuries are rare yet life-threatening events. The most easily accessible diagnostic tool to identify these patients would be CXR as it is still one of the standard diagnostic tools in the early assessment of severely injured patients with significant thoracic trauma (Abbreviated Injury Scale, AIS ≥3). This study evaluates the role of early CXR in the Trauma Resuscitation Unit (TRU) in the last diagnostic field where eFAST cannot provide an answer: detecting mediastinal vascular injury in severely injured patients.Method: This retrospective, observational, single-centre study included all primary blunt trauma patients of a 24 months time period, that had been admitted to the TRU. Mediastinal/chest (M/C) ratio measurements were taken from CXRs at three defined levels of the mediastinum. The accuracy of the CXR findings were compared to whole-body computed tomography scans (WBCT) and therapeutic consequences were observed. Additionally a 15 years (2005–2019) time period out of the TraumaRegister DGU® was evaluated regarding usage of eFAST, CXR und WBCT in Level-1, -2, and − 3 Trauma Centres in Germany.Results: A total of 267 patients showed a significant blunt thoracic trauma (27 with mediastinal vascular injury (VThx)). The initial CXR in a supine position was unreliable for detecting mediastinal vascular injury. The sensitivity and specificity at different thresholds of maximum M/C ratio (2.0–3.0) were not clinically acceptable. The aortic contour and haemato- and pneumothorax were not reliably detected in the initial CXRs. No significant differences in the cardiac silhouette were observed between patients with or without mediastinal vascular injury (mean cardiac width, 136.5 mm, p = 0.44). No therapeutic consequences were drawn after CXR in the study period. The data from the TR-DGU (N = 251,095) showed a continuous reduction of CXR from 75% (2005) to 25% (2019), while WBCT raised from 35% to a steady level of about 80%. This development was seen in all trauma hospitals almost simultaneously.Conclusion: In present guidelines, CXR remains an integral diagnostic element during early TRU management, although several prior publications show the superior role of eFAST. Our data support that in most cases, CXR is time consuming and provides no benefit during initial management of severely injured patients and might delay the use of WBCT. The trauma centres in Germany have already significantly reduced the usage of CXR in the TRU. We therefore recommend to revise current guidelines and emphasise eFAST and rapid diagnostic through WBCT if rapidly available.

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