Whole-body computed tomography in polytrauma: techniques and management.
An interdisciplinary team should be involved in the diagnosis and management of severely injured patients. The adoption of criteria for starting treatment for multiple trauma avoids underestimation of seriousness of injury. These criteria are established by the circumstances of the accident, the patterns of trauma, and the vital findings. Basic diagnosis comprises a limited number of plain films in the trauma room, including supine chest, lateral cervical spine, and pelvis, and ultrasound of abdomen, pleura, and pericardium. Organ diagnosis using CT is complementary and depends on the clinical findings and findings from the basic investigations. We recommend spiral CT (skull base 2/2/4 mm, cerebrum 8/8/8 mm native) and after intravenous contrast medium thoracic (5/7.5/5 mm) and abdominal CT (8/12/8 mm). Image reconstruction of bony structures can be added. The CT and the trauma center should be in close proximity; time-consuming transfers must be avoided. If this is not possible, a CT can be integrated in the trauma room. Our hospital trauma registry contains over 2200 entries. A quality committee has been established and external quality control is implemented.
Department of Radiology, Klinikum der Universität München, Innenstadt, Nussbaumstrasse 20, Germany. lin@ch-i.med.uni-muenchen.de
Ulrich
U
Linsenmaier
Michael
M
Krötz
Hannes
H
Häuser
Clemens
C
Rock
Johannes
J
Rieger
Klaus
K
Bohndorf
Klaus Jürgen
KJ
Pfeifer
Maximilian
M
Reiser
D006801:Humans; D009104:Multiple Trauma / Q000000981:diagnostic imaging* / Q000601:surgery / Q000628:therapy; D015641:Radiography, Interventional; D014057:Tomography, X-Ray Computed / Q000379:methods*