The utility of computed tomography as a radiological investigation following multisystem trauma is already well established in current practice. This article examines the existing evidence and rationale behind the use of early computed tomography scanning in the management of the multisystem trauma patient, with a particular emphasis on the use of ‘whole body’ computed tomography scanning as a component of their initial management in the Emergency Department.
The use of computed tomography has been shown to be superior to plain radiography for the detection of injuries in important body regions including the spine, thorax, abdomen and pelvis. Computed tomography scan of the head and cervical spine is also well established as the first investigation of choice for significant traumatic brain injury. The potential benefits of whole body computed tomography include reduced time to diagnosis and intervention, as well as significant improvements in clinical outcome and survival. Concerns regarding a whole body computed tomography approach relate to the increased ionising radiation dosage that patients will be exposed to, and perceived risks of the secondary transfer and scanning room environment itself. Potential barriers to the use of whole body computed tomography are also explored and discussed.
This article also presents a proposed clinical algorithm derived from the results of a recent Delphi study into whole body computed tomography following blunt multitrauma, along with conclusions and recommendations from the subject matter panel review process.
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