Emergency radiology
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Emergency radiology · Jul 2004
ReviewControversies in emergency radiology. CT versus ultrasound in the evaluation of blunt abdominal trauma.
There has been controversy regarding ultrasonography (US) versus CT in blunt abdominal trauma (BAT). Each modality has its strengths and weaknesses. US is fast and allows resuscitative efforts to proceed while the patient is being scanned. ⋯ However, CT involves ionizing radiation, cannot be performed portably, and requires only visual monitoring while scanning. Given each modality's strengths and weaknesses we conclude that CT is the preferred examination when the BAT patient is stable or moderately stable, enough to be taken to CT. If a BAT patient is unstable, US is beneficial in screening for certain injuries or large hemoperitoneum prior to an exploratory laparotomy.
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Emergency radiology · Jul 2004
Patient encounter time intervals in the evaluation of emergency department patients requiring abdominopelvic CT: oral contrast versus no contrast.
The aim of the study was to assess various time intervals during patient encounters involving unenhanced (NECT) versus oral-contrast-enhanced (CECT) abdominopelvic (A/P) CT performed in the emergency department (ED) on adult patients presenting with acute abdominal pain. Computerized patient order entry and administrative data as well as scans themselves were retrospectively evaluated at a high-volume (107,000 visits per annum) regional medical center urban ED for a period of 30 consecutive days. All adult patients who had CT of abdomen and pelvis for abdominal pain during the 30 days of the study period were included. ⋯ There are significant time interval differences between CECT and NECT during patient encounters involving adults presenting with abdominal pain to the ED. The differences are greater than the amount of time allotted for opacification of small bowel (90 min). Baseline data such as these may prove useful in assessing the efficacy of scan techniques and improving resource utilization.
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Emergency radiology · Jul 2004
The use of sonography versus computed tomography in the triage of blunt abdominal trauma: the European perspective.
The management of the trauma-emergency patient has become an important political and economic issue and one of the major challenges of the industrialized countries. In Europe ultrasonography is always part of the basic work-up, following physical examination, whereas computed tomography (CT) remains a second-line investigation. ⋯ The clinical value of CT is unquestioned; what is questionable is only its systematic use. With the growing demand for trauma care, screening ultrasonography can lower the number of inappropriate CT examinations.