Trauma Computed Tomography in the Modern Era: Not Always Quick and Safe.


Journal

The American surgeon
ISSN: 1555-9823
Titre abrégé: Am Surg
Pays: United States
ID NLM: 0370522

Informations de publication

Date de publication:
Dec 2021
Historique:
pubmed: 16 11 2021
medline: 15 12 2021
entrez: 15 11 2021
Statut: ppublish

Résumé

Computed tomography (CT) has emerged as the diagnostic modality of choice in trauma patients. Recent studies suggest its use in hemodynamically unstable patients is safe and potentially lifesaving; however, the incidence of adverse events (AE) during the trauma CT scanning process remains unknown. Over a 6-month period at a Level 1 trauma center, data on patients undergoing trauma CT (whole-body CT (WBCT) +/- additional CT studies) were prospectively collected. All patients requiring a trauma team activation (TTA) were included. Adverse events and specific time intervals were recorded from the time of TTA notification to the time of return to the resuscitation bay from the CT suite. Of the 94 consecutive patients included in the study, 47.9% experienced 1 or more AE. Median duration away from the resuscitation bay for all patients was 24 minutes. Patients with AE spent a significantly longer time away from the resuscitation bay and had longer scan times. Vasopressor support and ongoing transfusion requirement at the time of CT scanning were associated with AE. Adverse events of varying clinical significance occur frequently in patients undergoing emergent trauma CT. A standard trauma CT protocol could improve the efficiency and safety of the scanning process.

Sections du résumé

BACKGROUND BACKGROUND
Computed tomography (CT) has emerged as the diagnostic modality of choice in trauma patients. Recent studies suggest its use in hemodynamically unstable patients is safe and potentially lifesaving; however, the incidence of adverse events (AE) during the trauma CT scanning process remains unknown.
STUDY DESIGN METHODS
Over a 6-month period at a Level 1 trauma center, data on patients undergoing trauma CT (whole-body CT (WBCT) +/- additional CT studies) were prospectively collected. All patients requiring a trauma team activation (TTA) were included. Adverse events and specific time intervals were recorded from the time of TTA notification to the time of return to the resuscitation bay from the CT suite.
RESULTS RESULTS
Of the 94 consecutive patients included in the study, 47.9% experienced 1 or more AE. Median duration away from the resuscitation bay for all patients was 24 minutes. Patients with AE spent a significantly longer time away from the resuscitation bay and had longer scan times. Vasopressor support and ongoing transfusion requirement at the time of CT scanning were associated with AE.
CONCLUSION CONCLUSIONS
Adverse events of varying clinical significance occur frequently in patients undergoing emergent trauma CT. A standard trauma CT protocol could improve the efficiency and safety of the scanning process.

Identifiants

pubmed: 34780304
doi: 10.1177/00031348211061330
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1690-1695

Auteurs

Cameron Ghafil (C)

Division of Acute Care Surgery, 23336LAC+USC Medical Center, Los Angeles, CA, USA.

Kazuhide Matsushima (K)

Division of Acute Care Surgery, 23336LAC+USC Medical Center, Los Angeles, CA, USA.

Hiroto Chiba (H)

Division of Acute Care Surgery, 23336LAC+USC Medical Center, Los Angeles, CA, USA.

Renqing Wu (R)

Division of Acute Care Surgery, 23336LAC+USC Medical Center, Los Angeles, CA, USA.

Heeseop Shin (H)

Department of Radiology, 23336LAC+USC Medical Center, Los Angeles, CA, USA.

Michael Menchine (M)

Department of Emergency Medicine, 23336LAC+USC Medical Center, Los Angeles, CA, USA.

Kenji Inaba (K)

Division of Acute Care Surgery, 23336LAC+USC Medical Center, Los Angeles, CA, USA.

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