Emergency CT

Abstract

Trauma is one of the leading causes of death in people under the age of 44 years (Rivara et al. 2015). Trauma also has a substantial financial impact on the healthcare system, accounting for over one-third of all emergency department visits and resulting in over $80 billion per year in direct medical care costs in the USA (WISQARS 2016). A significant cause of preventable deaths in trauma is delay in proper surgical care. Significant injuries are overlooked at a high rate in patients with major trauma (Rivara et al. 2015). In particular, the physical examination is unreliable in patients with a reduced level of consciousness (Rivara et al. 2015). With the marked decrease in the use of diagnostic peritoneal lavage, diagnosis of abdominal injuries now relies almost exclusively on the interpretation of computed tomography (CT) examinations (Catre 1995). As a member of the trauma team, the radiologist plays a significant role by contributing to the rapid diagnosis of critical and emergent diagnoses (Clarke et al. 2002; Schueller et al. 2015). Until a few years ago, CT scanning was performed at the end of the clinical evaluation of the patient. However, with the advance of high-speed assessment by multi-detector CT (MDCT), scanning can now be performed immediately upon patient arrival in the trauma bay. As a result, the mortality rate has significantly decreased, especially in cases of severe trauma (Schueller et al. 2015; Jiang et al. 2014).