1. How do you decide which patients with abdominal trauma need a CT?
2. Do you order chest CTs on stable patients with focal chest wall tenderness and a normal AP chest X-ray?
3. Do you pan scan in stable patients? If so, when and why?
4. Do you have clinical situations in which a negative FAST exam precludes the need for a CT?
It all depends in the pt meets our trauma alert criteria… if trauma alert, pan scan is the norm, no matter how stable….
HOWEVER, our trauma surgeons are somewhat enlightened and if
1) hemodynamically stable
2) clear sensorium (no head injury, no intoxicants)
3) nontender belly
4) negative FAST
then they don’t get a CT. They can go to obs unit & get a repeat exam & FAST. If they still meet all of the above criteria, they go home with no CT.
Sadly, this is only a small percentage of our trauma patients (mostly due to #2)