Significant resources are expended on the assessment of trauma patients who arrive at the trauma center based solely on mechanism of injury. We hypothesized that rollover motor vehicle crashes (ROMVC) are not an independent predictor for trauma center care. All patients seen between January 1, 2001, and December 31, 2005, involved in a ROMVC, were reviewed. Patients with any confounding factors were removed, leaving those transported to the trauma center based on mechanism only. Five hundred sixty-nine patients were transported to our center for the mechanism of ROMVC. Of the 569 patients, 369 (65%) were evaluated and discharged with minimal Injury Severity Score and regional Abbreviated Injury Scale scores. Of the remaining 200 (35%) patients admitted, 130 required surgery, predominantly for closed extremity and facial fractures. Six patients required immediate surgery for life-threatening injuries: 3 splenectomies, 1 subdural evacuation, and 2 vascular repairs (1.1%). Of the remaining 123 (4.2%) patients requiring surgery, 24 required urgent surgery (2 craniotomies, 9 laparotomies, and 13 spinal fixations). None of the patients with spinal injury had neurologic deficit. Eight patients were admitted to the intensive care unit for neurologic monitoring (1.4%). Only 6.7 per cent benefited from initial Trauma Triage Criteria. Therefore, ROMVC is not an independent predictor of the need for trauma center evaluation or admission. The majority of these patients could be safely evaluated and treated at nontrauma centers or transferred later.
This study reviews the initial clinical experience using a portable computed tomographic (CT) scanner in the trauma resuscitation unit (TRU), intensive care units (ICUs), and operating rooms (ORs) of a large trauma center. Data were collected on the first 200 patients scanned within the trauma center (including 92 in the TRU, 92 in the ICUs, and 16 in the ORs) over the first 5 months of operation. Evaluation forms were completed by interpreting radiologists, CT technicians operating the system, and nurses~clinicians involved with patients being scanned. Information sought included subjective image quality, ease of use, software and hardware limitations, accessibility to and monitoring of patients during scanning, mobility, and perceived advantages or limitations compared to
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