• J Trauma · Mar 2009

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

    • Thomas Erik Wurmb, Peter Frühwald, Witiko Hopfner, Thorsten Keil, Markus Kredel, Jörg Brederlau, Norbert Roewer, and Herbert Kuhnigk.
    • Department of Anesthesiology, University Hospital Wuerzburg, Wuerzburg, Germany. wurmb_t@klinik.uni-wuerzburg.de
    • J Trauma. 2009 Mar 1;66(3):658-65.

    ObjectiveWhole-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).MethodsObservational 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.ResultsThe 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.ConclusionA 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.

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