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INTRODUCTION: Trauma remains a major cause of mortality and morbidity, particularly among young adults. A major trauma (whole-body) CT protocol based upon mechanism of injury was investigated in a busy emergency department. METHODS: Trauma patients presenting in two 3-month periods before and after the introduction of a major trauma CT protocol were identified. The mechanism of injury, Injury Severity Score, radiological imaging performed and injuries detected were recorded. RESULTS: More eligible patients received major trauma CT scanning post-protocol than pre-protocol (87/114 (76%) vs 44/94 (47%)). There were no adverse effects attributable to major trauma CT. Seventeen injuries were detected post-protocol that would not have been detected had imaging been conducted based on clinical suspicion rather than mechanism of injury. In three cases an immediate intervention was required. CONCLUSION: Our major trauma CT protocol, based on mechanism of injury, resulted in substantial changes in clinical management in a small number of patients without any increase in adverse events. However, it is not a substitute for clinical acumen in the initial assessment of trauma patients.

Original publication




Journal article


Emerg med j

Publication Date





378 - 382


Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Clinical Protocols, Female, Humans, Infant, Infant, Newborn, Injury Severity Score, Male, Middle Aged, Multiple Trauma, Statistics, Nonparametric, Tomography, X-Ray Computed, Trauma Centers, United Kingdom