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Table 19 Section 10: Summary: A proposal for two WBCT—Protocols in the Trauma Care

From: European Society of Emergency Radiology: guideline on radiological polytrauma imaging and service (short version)

Key question: Is one standard CT protocol sufficient?
No Statement(s) Cons Grade Cons
10.1 Within the framework of radiological polytrauma management, at least two different WBCT protocols should be maintained as institutional standards. One should be optimised with regard to radiation dose yielding high diagnostic validity but prioritising lower radiation burden (Dose Protocol). The other one is a compromise, prioritising rapid diagnosis and very high diagnostic validity over the potential risks of increased radiation burden (Time/Precision Protocol) 100%
strong
GPP
A
100%
strong
10.2 The Time/Precision Protocol should be preferred for polytrauma patients with life-threatening injuries or haemodynamically unstable conditions 88%
normal
GPP
A
100%
strong
10.3 The Dose Protocol should be preferred for polytrauma patients provided they do not have obvious life-threatening injuries or are haemodynamically unstable 100%
strong
GPP
A
100%
strong
Literature: No literature search was conducted
Comments: It has been proven that the maintenance of a protocol standard for whole-body CT after polytrauma increases the probability of survival [149]. As a possible consequence of this fact, the experts at the conference observed an increase in Emergency Trauma Room admissions who subsequently receive a WBCT. In parallel, the ESER experts share the impression that the number of patients with minor injuries who undergo WBCT has also increased. The consensus group concluded that a single standard protocol can rarely do justice to this varied situation. A more refined but nevertheless simple differentiation would be desirable with regard to the essential influencing parameters: Injury severity, patient condition, patient age including the probability of relevant comorbidities and/or medication, dose aspects especially with regard to patient age. The other previous recommendations remain unaffected