BestBets – Whole-body CT In trauma patients

This week Simon, Dan and Rick discuss a great BET from Hong Kong. Should we routinely CT our major trauma patients from vertex to symphysis?? We think so, but what’s the evidence. Giles and Scott from Hong Kong have written the BET that gives us an answer. Read the BET here http://www.bestbets.org/bets/bet.php?id=1779 and then listen to the podcast. S

Posted by Simon Carley

Professor Simon Carley MB ChB, PGDip, DipIMC (RCS Ed), FRCS (Ed)(1998), FHEA, FAcadMed, FRCEM, MPhil, MD, PhD is Creator, Webmaster, owner and Editor in Chief of the St Emlyn’s blog and podcast. He is Professor of Emergency Medicine at Manchester Metropolitan University and a Consultant in adult and paediatric Emergency Medicine at Manchester Foundation Trust. He is co-founder of BestBets, St.Emlyns and the MSc in emergency medicine at Manchester Metropolitan University. He is an Education Associate with the General Medical Council and is an Associate Editor for the Emergency Medicine Journal. His research interests include diagnostics, MedEd, Major incidents & Evidence based Emergency Medicine. He is verified on twitter as @EMManchester

  1. How does this improve training for young surgeons? And your er doctors in training..? Is it airway breathing ct scan..the new algorithm. Now many elderly get man scanned..but how many intoxicated patients who are awake with isolated head injuries will get man scanned? What happened to physical exam? What happened to serial exams..neuro and abdominal? What happened to the extended fast? What about the patient who walked in and polytrauma? There has to be a line of wise judgment? What do you do in austere environments? Over reliance of pan scanned will ill prepare you for clinical judgment no? What vital injuries were missed when man scans not done? Did mortality or morbidity change really? Units of blood needed when it wasn’t or vice versa? Patient paralyzed by missed fractured spine or not? Things to think about. Pan scans..not a new topic in the USA. Bet the trauma seen in Hong Kong may be much different than in some cities in USA?

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  2. I’m not sure in any emergency system this is up for debate, is it?
    BUT, who not to do them on is the gazillion $ question. I constantly run into battles with respect to junior alumni of major trauma units just pan scanning the proverbial shite out of anything that trips into the department.
    Caveat
    Non- tropical Australian based ED physician
    😉

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Thanks so much for following. Viva la #FOAMed

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