Login
Site Search
Trauma-List Subscription

Subscribe

Would you like to receive list emails batched into one daily digest?
No Yes
Modify Your Subscription

Modify

Home > List Archives

Whole-body CT

Robert Crochelt robertc at searhc.org
Fri Jan 27 19:14:55 GMT 2012


Pret,
I believe these guidelines will be helpful to providers in local hospitals.

Regards,
Bob Crochelt

On Fri, Jan 27, 2012 at 5:12 AM, Bjorn, Pret <pbjorn at emh.org> wrote:

> BIG 'AYUH' from Maine.  Our EMS Trauma Advisory Committee is preparing
> this guideline (attached, currently in draft) for addition to our other
> online advice to trauma system providers.  Comments or suggestions welcome.
>
> Pret Bjorn, RN
> Bangor, ME USA
>
>
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org [mailto:
> trauma-list-bounces at trauma.org] On Behalf Of KMATTOX at aol.com
> Sent: Tuesday, January 24, 2012 8:21 PM
> To: trauma-list at trauma.org
> Subject: Re: Whole-body CT
>
>  Any test, including lab tests, routine X-rays, CT scans, etc, should
> trongly believe that ONLY be done if the person ordering the test can write
> a progress note stipulating what it is that they expect to find from the
> test and  how the results will influence decision making compared to if the
> test
> was NEVER  performed.      With such a rule, more  than  85-92% of all
> tests,
> especially CT scans for trauma, appendicitis, etc. etc.  would be
> eliminated.
>
> I stongly believe that our over reliance on CT scaning, especially CT
> Angiography contributes to VOMIT - Victim of Modern Imaging Technology from
> false positive and over read CT scans.    AND I do believe that  society
> will
> hold the medical profession accountable for this excessive  radiation, and
> excessive costs.
>
> k
>
>
> In a message dated 1/24/2012 6:19:48 P.M. Central Standard Time,
> dnepogodiev at googlemail.com writes:
>
> Dear  trauma.org members,
>
> I'd be very interested in the list's expert views  on CT abdomen in
> trauma. It comes after an article in the Lancet from 2009  that concluded
> that between 17 and 32 trauma patients need to undergo  whole-body CT to
> prevent one trauma death. Clearly there is a need to  weigh up the costs
> and radiation exposure of CT against their  benefits.
>
> Major unstable polytrauma patient with positive abdominal  signs =
> theatre. And major trauma patients who are stable but have a  tender
> abdomen = CT. I wonder whether the haemodynamically stable, awake patient
> with, say, a broken clavicle, broken ankle and non-tender abdomen needs a
> whole-body CT? What about long bone fractures, e.g.
> femur, but still asymptomatic abdomen? Is a distracting injury a valid
> indication?
>
> In trauma, should CT scans of the abdomen be performed  on awake,
> non-agitated patients with asymptomatic abdomens, but who have  positive
> mechanism of injury/ other injuries? Or should CT abdomen be  reserved for
> the symptomatic abdomen/ intubated patient? What does the  list feel is an
> acceptable “number needed to treat” of patients scanned to  prevent one
> death/ result in one surgical  intervention?
>
> Huber-Wagner, S., R. Lefering, et al. (2009). "Effect of  whole-body CT
> during trauma resuscitation on survival: a retrospective,  multicentre
> study." Lancet 373(9673): 1455-1461.
>
> With many thanks  for your thoughts.
>
> Dmitri, University of Birmingham,  UK
> --
> trauma-list : TRAUMA.ORG <http://trauma.org/>
> To change your settings or unsubscribe  visit:
> http://www.trauma.org/index.php?/community/
> --
> trauma-list : TRAUMA.ORG <http://trauma.org/>
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
>
> -----------------------------------------------------------------------------------------------------------
> This email message, including any associated files, is for the sole use of
> the intended recipient(s)
> and may contain information that is confidential, privileged, or subject
> to copyright, trade secret
> or other protection. This message also may contain information protected
> by state and federal privacy
> laws that are enforced through serious civil and criminal sanctions. Any
> unauthorized review, use,
> disclosure, or distribution is prohibited. If you are not an intended
> recipient of this message,
> please notify the sender immediately by replying to this e-mail, and
> delete the original and all
> copies of this message from your computer or other device.
>
> --
> trauma-list : TRAUMA.ORG <http://trauma.org/>
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
>



-- 
Bob Crochelt, MD, PhD, FACS
Chief of Surgery
Mt. Edgecumbe Hospital
Sitka, Alaska, USA

-- 
-- 
This e-mail and any files transmitted with it are confidential and
are intended solely for the use of the individual or entity to whom
they are addressed. This communication may contain material protected
by evidentiary privileges including the physician-patient privilege,
psychotherapist-patient privilege, attorney-client privilege and federal
privacy laws. If you are not the intended recipient or the individual
responsible for delivering the e-mail to the intended recipient, please
be advised that you have received this e-mail in error and that any
use, dissemination, forwarding, printing, or copying of this e-mail is
strictly prohibited. If you have received this e-mail in error, please
immediately notify the sender by replying to this message. You may also 
notify SEARHC by telephone at (907) 966-8418. You will be reimbursed 
for reasonable costs incurred in notifying us.


More information about the trauma-list mailing list