Trauma Imaging – Clinical Pathway

Appropriate clinical decision-making in the initial evaluation and management of?trauma patients in the emergency department is critical to optimize patient outcomes.

Our August supplement,?Current Topics in Emergency Trauma Care, provides evidence-based recommendations for determining appropriate diagnostic imaging modalities in trauma patients, best practices and strategies in initial resuscitation of the trauma patient, and clinical decision tools to aid in decision-making.

Part 1 of the supplement, “Limiting Radiation Exposure in Trauma Imaging,” reviews best practices in diagnostic radiology for evaluation of the trauma patient and discusses approaches to optimize diagnostic assessment while limiting radiation exposure. To help you with the decision-making process, we’ve included the table below, which is also included in the supplement.

Table 4. Clinical Decision Rules for Trauma Imaging

Clinical IssuesDecision RulesReferences
Cervical spine evaluation in blunt trauma patientsNEXUS Low-Risk Criteria for C-Spine Imaging
and
Canadian C-Spine Rule
Hoffman JR et al, 200022?Stiell IG et al, 200123
Imaging of patients with minor head injuryCanadian CT Head RuleStiell IG et al, 200124
Selective chest imaging in blunt trauma patientsNEXUS Chest Decision Instrument for Blunt Chest TraumaRodriguez RM et al, 201325
Evaluation of ankle/foot injuriesOttawa Ankle RuleStiell IG et al, 199326
Evaluation of knee injuriesOttawa Knee RuleStiell IG et al, 199627

Abbreviations: C-spine, cervical spine; CT, computed tomography; NEXUS, National Emergency X-Radiography Utilization Study.


The hyperlinks in?Table 4?provide access to each clinical decision rule tool on MDCalc. For more information about each clinical decision tool, go to: www.ebmedicine.net/TraumaImaging.

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Last Updated on June 12, 2022

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