Der Radiologe
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Head injury alone or in combination with multiple trauma is the main cause of death and severe disability in individuals under 45 years old. This review is intended to describe the relevant imaging modalities, to analyze their specific value and limitations and to illustrate the most important radiologic findings. The indications for diagnostic imaging within the context of an interdisciplinary linkage of diagnostic and therapeutic measures are discussed. ⋯ Suitable constructive prerequisities, an interdisciplinary care concept and integration of the radiologist in hospital-adapted diagnostic and therapeutic algorithms significantly improves the outcome of patients with acute head injury. Beside the correct diagnosis itself the time to establish a diagnosis above all has a crucial impact on successful management and good outcome of these patients.
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In the early clinical phase the comprehensive imaging of patients with multiple trauma using helical CT is already established. Aim of this study was to assess whether MSCT may improve the patient management and the diagnostic results. The procedure is designed as follows: after life-thretening treatment x-ray of chest and ultrasound are carried out in the emergency room. ⋯ The total lethality decreased by approximately 4%. Advantages for the patient arose from the standardized examination protocol using multislice CT. If integrated in an interdisciplinary management concept, it is a good compromise between examination time, comprehensive diagnostic imaging, life-saving therapeutic procedures, and therapy planning.
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Comparative Study
[Interdisciplinary shock room management: personnel, equipment and spatial logistics in 3 trauma centers in Europe].
To analyse common and divergent features of staff-related, equipmental and spatial/logistical concepts of three large trauma centers of highest health care level. ⋯ Trauma centers have to meet certain personnel and technical prerequisites to guarantee a temporally optimised care for multiple injured patients. Differences between the three centers concerning the logistic sequence and the radiologic examination techniques used are mainly due to variable emphasis put on CT in the initial phase of patient care.
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Development of a concept for structured diagnostic imaging in patients with multiple trauma. ⋯ Structured diagnostic imaging of multiple injured patients leads to a standardization of diagnosis and therapy and ensures constant process quality.
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Evaluation of trauma systems requires a complete and exact injury classification. The purpose of this study was the introduction of the Abbreviated injury scale (AIS) for radiological trauma scoring. The development of these easy to use coding tools is essential for prompt quality management of trauma. ⋯ Computed tomography enables in combination with a standardized injury description exact trauma scoring. Quality management of trauma care depends on a valid and reliable calculation of the probability of survival using TRISS.