Whole body computed tomography for trauma patients in the Nordic countries 2014: survey shows significant differences and a need for common guidelines.
BACKGROUND
Whole body computed tomography in trauma (WBCTT) is a standardized CT examination of trauma patients. It has a relatively high radiation dose. Therefore, well-defined clinical indications and imaging protocols are needed. This information regarding Nordic countries is limited.


OBJECTIVE
To identify Nordic countries' WBCTT imaging protocols, radiation dose, and integration in trauma care, and to inquire about the need for common Nordic guidelines.


METHODS
A survey with 23 multiple choice questions or free text responses was sent to 95 hospitals and 10 trauma centers in and outside the Nordic region, respectively. The questions were defined and the hospitals selected in collaboration with board members of "Nordic Forum for Trauma and Emergency Radiology" (www.nordictraumarad.com).


RESULTS
Two Nordic hospitals declined to take part in the survey. Out of the remaining 93 Nordic hospitals, 56 completed the questionnaire. Arterial visualization is routine in major trauma centers but only in 50% of the Nordic hospitals. The CT scanner is located within 50 m of the emergency department in all non-Nordic trauma centers but only in 60% of Nordic hospitals. Radiation dose for WBCTT is in the range of 900-3600 mGy × cm. Of the 56 responding Nordic hospitals, 84% have official guidelines for WBCTT. Eighty-nine percent of the responders state there is a need for common guidelines.


CONCLUSIONS
Scanning protocols, radiation doses, and routines differ significantly between hospitals and trauma centers. Guideline for WBCTT is presently defined locally in most Nordic hospitals. There is an interest in most Nordic hospitals to endorse new and common guidelines for WBCTT.
Faculty of Medicine, Uppsala University, Uppsala, Sweden.
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Wiklund
Department of Radiology, Helsinki University Central Hospital, Helsinki Medical Imaging Center, Helsinki, Finland Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology, Department of Radiology, Karolinska Institutet and Karolinska University Hospital Huddinge.
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Koskinen
Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Uppsala, Sweden.
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F
Linder
Department of Medical Physics, Uppsala University Hospital, Uppsala University, Uppsala, Sweden.
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PE
Åslund
Department of Surgical Sciences, Section of Radiology, Uppsala University, Uppsala, Sweden hampus.eklof@radiol.uu.se.
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Eklöf
D003287:Contrast Media; D006801:Humans; D011829:Radiation Dosage; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed / Q000379:methods*; D051598:Whole Body Imaging; D014947:Wounds and Injuries / Q000000981:diagnostic imaging* / Q000453:epidemiology
D003287:Contrast Media
CT; adults; contrast agents – intravenous; equipment; radiation safety; trauma