title: Whole-body multislice computed tomography as the first line diagnostic tool in patients with multiple injuries: the focus on time.
abstract: OBJECTIVE
  Whole-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).
  
  
  METHODS
  Observational 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.
  
  
  RESULTS
  The 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.
  
  
  CONCLUSIONS
  A 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.
authors.affiliation: Department of Anesthesiology, University Hospital Wuerzburg, Wuerzburg, Germany. wurmb_t@klinik.uni-wuerzburg.de
authors.forename: Thomas Erik
authors.initials: TE
authors.lastname: Wurmb
authors.forename: Peter
authors.initials: P
authors.lastname: Frühwald
authors.forename: Witiko
authors.initials: W
authors.lastname: Hopfner
authors.forename: Thorsten
authors.initials: T
authors.lastname: Keil
authors.forename: Markus
authors.initials: M
authors.lastname: Kredel
authors.forename: Jörg
authors.initials: J
authors.lastname: Brederlau
authors.forename: Norbert
authors.initials: N
authors.lastname: Roewer
authors.forename: Herbert
authors.initials: H
authors.lastname: Kuhnigk
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002648:Child; D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital; D004867:Equipment Design; D005260:Female; D005858:Germany; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging* / Q000601:surgery; D012151:Resuscitation / Q000295:instrumentation; D012189:Retrospective Studies; D013673:Technology Assessment, Biomedical; D013996:Time and Motion Studies; D036542:Tomography, Spiral Computed / Q000295:instrumentation*; D014218:Triage; D051598:Whole Body Imaging / Q000295:instrumentation*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000601:surgery; D055815:Young Adult