Article Text

Download PDFPDF

1657 Trauma imaging appropriateness in paediatric patients conveyed to a trauma unit compared to a major trauma centre – a retrospective observational study
  1. Owen Hibberd1,
  2. James Price2,
  3. Amy Laurent2,
  4. Shruti Agrawal3,
  5. Edward Barnard4
  1. 1Cambridge University Hospitals NHS Foundation Trust and Blizard Institute, Queen Mary University London
  2. 2Cambridge University Hospitals NHS Foundation Trust
  3. 3Cambridge University Hospitals NHS Foundation Trust and University of Cambridge
  4. 4Cambridge University Hospitals NHS Foundation Trust and Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine (Research and Clinical Innovation)


Aims, Objectives and Background Appropriate and timely imaging improves trauma outcomes. In adults, the default is whole-body computed tomography (CT). However, in children more selective imaging should be used. In those requiring CT, the national standard is imaging ≤30mins of arrival. The aims of this study were to compare appropriateness of CT and time to initial CT in paediatric trauma patients conveyed directly to a major trauma centre (MTC) with those initially treated in a trauma unit (TU) and then transferred to an MTC.

Method and Design A retrospective observational study in the East of England MTC (2015–2020). All paediatric trauma patients meeting Trauma Audit Research Network (TARN) criteria who arrived at the MTC ≤24hr of injury and underwent CT imaging within 12 hours of arrival were included.

Data were obtained from the MTC trauma office and clinical records were independently reviewed by two authors. The Royal College of Radiologists guideline for paediatric trauma was used to assess the appropriateness of the CT imaging strategy.„Combined data were stored in a Microsoft Excel sheet and analysed in Prism 9 for macOS (GraphPad). Data are reported as number (percentage), and median [inter-quartile range]. Proportions were compared with a Fisher’s Exact test; differences between median values were compared with a Mann-Whitney U test.

Results and Conclusion In the study period n=315 patients were identified. 229 (72.7%) underwent CT <12hrs and were included in the analysis: n=93 MTC, n=136 TU, table 1. CT imaging was judged as appropriate in n=77/93 (82.8%) MTC and n=104/136 (76.5%) TU scans, p=0.32. The median time to first CT was 35.0 [26.0–75.0] minutes MTC, and 76.0 [48.0–109.0] minutes TU, p<0.0001.

Abstract 1657 Table 1

CT appropriateness and timing associated with transfer status at a single MTC

We have demonstrated room for improvement in paediatric CT trauma imaging appropriateness across the network, but this is not significantly different between the MTC and TUs. However, time to initial trauma CT was significantly shorter in the MTC.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.