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Tue Dec 25 06:04:34 GMT 2007

In a message dated 12/25/2007 12:38:41 A.M. Eastern Standard Time,  
ccrone at charter.net writes:

I work  at a small, rural ER (about 18, 000 annual ED volume).  We have no  
FAST/Ultrasound immediately available at all times.  If we have a case of  
blunt abdominal trauma & order a CT scan, our radiologist demands that we  have 
the patient drink oral contrast & wait 2 hours for the CT to be  performed.  It 
then takes another 30 minutes for the report to be  obtained.    What do other 
institutions currently do regarding the  use of oral contrast when obtaining 
abdominal/pelvic CT's for blunt abdominal  trauma in a hemodynamically stable 
patient-- with suspected internal  injuries?

Thanks 

perhaps i am old fashion but i find gastrointestinal opacification  
particularly helpful in evanluating the pancreas and duodenum. I think that  
opacification small intestind is a hit or miss thing. I don't wait a couple of  hours, i 
think you can give 300-400 ml of GI contrast at the time of requesting  the 
scan and top it off with another 300 ml at the time of the scan. 

if your radiologist is in house, then a report should be available in 10  
minutes. if he or she must drive to the hospital, then they can time it pretty  
well from the time the scan STARTS.  Of course the availability of  teleimaging 
should allow your radiologist to read it  faster.

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