CT Scans in Primary Survey for Polytrauma Patients

Abstract

Managing critically injured patients are challenging. Victims of major trauma often present with a host of unknowns including the exact site and nature of injury with a need for urgent diagnosis and resuscitation. It takes significant clinical expertise to detect multiple injuries and implement life or limb saving treatment within a short period of time. Conventional radiographs and focused assessment with sonography for trauma (FAST) scans are useful adjuncts to help in initial diagnosis. Conventional computer tomography (CT) investigations have been used for secondary survey in these scenarios. We reviewed the guidelines that regulate the use of CT scans in multiple injured patients in the UK. CT imaging is rapidly emerging as an adjunct to primary survey. It allows quick detection of major organ injury allowing focussed treatment whilst simultaneous initial resuscitation is underway. Availability of adequate resources is needed for widespread adaptation of this technique that involves manpower, relocation and refurbishment of the CT suites. Although it is not yet clear if using CT imaging during primary survey reduces mortality, it surely results in more organised patient care and efficient use of resources in an acute setting.

Rationality of using whole-body computed tomography in trauma patients

“…The integration of WBCT into the early diagnostic protocol was a turning point, changing the pattern of initial trauma management. In daily practice, WBCT has become an integral part of primary survey as defined by the rules of the ATLS protocol, eliminating in many cases the need to carry out a secondary survey [16]. Such a procedure, in principle not formally included in the rules of trauma protocols, resulted from daily observation, and was additionally confirmed in scientific studies, indicating that the use of WBCT significantly reduces the time from patient's arrival to the emergency department until the diagnosis is made, thus allowing the treatment plan to be outlined and its priorities set out much faster [1].…”

Role of Multidetector CT in Evaluation of Polytrauma Patients

“…It is not always financially viable to relocate existing CT suites or built new ones near the emergency departments especially in small district general hospitals. However, it is recommended that all newly built CT suites should be near the emergency departments ensuring quick transfer of patients with minimal movement [17]. Since polytrauma management is based on a multidisciplinary approach characterized by a coordinated interaction between trauma surgeons, anaesthesiologists and radiologists, members of all involved disciplines need adequate teaching.…”

Fabrication of Patient Specific Genioplasty Surgical Template Using Investment Casting

“…To overcome, this CT scanner was designed by incorporating multiple X-rays around the gantry tube. Depending on the number of emitters and receivers the CT scanner specification varies [4][5][6]. In the initial days there used to be dual slice CT scanners, Advancement in technology now enable 256 slice CT scan.…”