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The use of whole-body CT for trauma patients: survey of UK emergency departments
  1. Christopher M Smith,
  2. Suzanne Mason
  1. Health Services Research, School of Health and Related Research, Sheffield, UK
  1. Correspondence to Christopher M Smith, Health Services Research, School of Health and Related Research, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK; cms029{at}doctors.org.uk

Abstract

Introduction Whole-body computed tomography (WBCT) is advocated for use in some trauma patients presenting to the emergency department (ED). It is unclear how widespread the use of WBCT is in the UK and the best way to select patients for WBCT remains controversial. The aim of this study was to investigate the current use and nature of WBCT policies in ED in the UK.

Methods A postal questionnaire was devised and distributed to lead doctors of 245 ED in the UK in May 2010. Two further rounds of questionnaires were sent out in June and July to non-responders.

Results 184/245 hospitals responded (75.1%). 41/184 (22.3%) ED had a WBCT policy. 43 (23.4%) further ED indicated that they used WBCT in certain cases, without a formal policy. Hospitals with a WBCT policy saw significantly more trauma cases than those that did not. Most hospitals with a WBCT policy used multiple criteria to decide which patients received WBCT, although there were variations in the timing of CT and in who could request it. Out-of-hours CT scans were less likely to be reported by a consultant radiologist, and reporting times were longer.

Discussion The use of WBCT in the UK is variable, although centres that see more trauma seem more likely to have a WBCT policy. The results do raise concerns about how effectively WBCT can be delivered, especially out of hours, but nationwide plans to reorganise trauma care may potentially affect how and at which ED WBCT is offered in the future.

  • CT/MRI
  • emergency care systems
  • emergency departments
  • imaging
  • major trauma management
  • multiple trauma
  • trauma
  • whole-body imaging
  • wounds and injuries

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Footnotes

  • Funding No commercial funding was received for this project. CMS undertook this work as part of a masters degree during an academic clinical fellowship funded by Yorkshire and the Humber Deanery.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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