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Trauma CT Explodes in Birmingham (2016-2018)
Poster Title: Trauma CT Explodes in Birmingham (2016-2018)
Submitted on 02 Nov 2018
Author(s): JP Jen, S Hussain
Affiliations: University Hospitals Birmingham
This poster was presented at BIR Annual Congress 2018
Poster Views: 697
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Poster Information
Abstract: Introduction: The use of whole body CT (WBCT, head to thigh contrast CT) scanning in trauma patients has exploded in recent years. WBCT is known to improve survival when used early in resuscitation, in theory justifying the high dose of around 20mSv. Our trust is a trauma unit that supports a regional trauma centre, providing a 24h WBCT service for patients that meet criteria.

Goal: To evaluate whether WBCT requests meet agreed major trauma criteria, and the outcome of these WBCTs.

Methods: We performed a retrospective re-audit of 91 patients over 101 days, from January to April 2018, building on data from 2 years ago.

Results: Compared to 2 years ago, 89% of trauma WBCT requests fulfilled 1 or more criteria, compared to 74%. The number of WBCTs per month increased from 12.5 to 30, a 240% increase. The number of positive scans (any injury detected) was 45, equivalent to a test sensitivity of 49%. Almost 80% of requests had “dangerous mechanism causing occult injury to >1 body region” as their primary criteria for WBCT.

Conclusion: Requesting for WBCT is highly accurate to our trust’s major trauma guidelines, agreed between the Radiology and Emergency departments, and derived from NICE Clinical Guidance 39 (Feb 2016). This is an improvement on our previous audit from 2 years ago, where only 74% of WBCT requests fulfilled 1 criterion. However, volume of WBCTs has increased 240% with a test sensitivity of 49%. It may be that this improvement in effective requesting has increased scan volume. Review of our WBCT criteria may be useful, following a discussion with A&E clinicians.
Summary: Whole body CT scans increased by 240% from 2016-2018. Proportion of completely normal scans was 51%.References: Linder et al, Scan J Trauma Resus Emerg Med (2016)Report abuse »
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