Radiological work-up after mass casualty incidents: are ATLS guidelines applicable?

Postma, I.L.E.; Beenen, Ludo F. M.; Bijlsma, Taco S.; Berger, Ferco H.; Heetveld, Martin J.; Bloemers, Frank W.; Goslings, J. C.

doi:10.1007/s00330-013-3072-y

Cited by 11 publications

(7 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Regarding this, recent guidelines for the management of bleeding and coagulopathy recommend that the time elapsed between injury and operation should be minimized [8]. Plain X-rays of the chest and pelvis, focused assessment sonograph trauma (FAST), and organ-specific computed tomography (CT) are conventional evaluation methods in the early diagnostic work-up in MTPs which is recommended by the Advanced Trauma Life Support (ATLS®) protocol [9],[10]. However, it often results in misdiagnosis of some potential life-threatening solid organ injuries and is time-consuming [4],[11]-[16].…”

Section: Introductionmentioning

confidence: 99%

Comparison of whole-body computed tomography vs selective radiological imaging on outcomes in major trauma patients: a meta-analysis

Jiang

et al. 2014

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

IntroductionThe purpose of this meta-analysis was to explore the value of whole-body computed tomography (WBCT) in major trauma patients (MTPs).MethodsA comprehensive search for articles from Jan 1, 1980 to Dec 31, 2013 was conducted through PubMed, Cochrane Library database, China biology medical literature database, Web of knowledge, ProQuest, EBSCO, OvidSP, and ClinicalTrials.gov. Studies which compared whole-body CT with conventional imaging protocol (X-ray of the pelvis and chest, trans-abdominal sonography, and/or selective CT) in MTPs were eligible. The primary endpoint was all-cause mortality. The second endpoints included: time spent in the emergency department (ED), the duration of mechanical ventilation, ICU and hospital length of stay (LOS), the incidence of Multiple Organ Dysfunction Syndrome (MODS) /Multiple Organ Failure (MOF). Analysis was performed with Review Manager 5.2.10 and Stata 12.0.ResultsEleven trials enrolling 26371 patients were analyzed. In MTPs, the application of WBCT was associated with lower mortality rate (pooled OR: 0.66, 95% CI: 0.52 to 0.85) and a shorter stay in the ED (weighted mean difference (WMD), −27.58 min; 95% CI, −43.04 to −12.12]. There was no effect of WBCT on the length of ICU stay (WMD, 0.95 days; 95% CI: −0.08 to 1.98) and the length of hospital stay (WMD, 0.56 days; 95% CI: −0.03 to 1.15). Patients in the WBCT group had a longer duration of mechanical ventilation (WMD, 0.96 days, 95% CI: 0.32 to 1.61) and higher incidence of MODS/MOF (OR, 1.44, 95% CI: 1.35-1.54; P = 0.00001).ConclusionsThe present meta-analysis suggests that the application of whole-body CT significantly reduces the mortality rate of MTPs and markedly reduces the time spent in the emergency department.

show abstract

Section: Introductionmentioning

confidence: 99%

Comparison of whole-body computed tomography vs selective radiological imaging on outcomes in major trauma patients: a meta-analysis

Jiang

et al. 2014

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

show abstract

“…The extensive use of computed tomographic scan in modern day trauma care might explain the decrease in missed spinal injuries. 29 The segmental distribution of injuries in our study revealed a low number of cervical fractures (14.8% of injuries) compared with general trauma literature (18%-21%). 2 , 3 , 16 In spinal fractures sustained in MVAs, the cervical spine comprises about 40% of all spine fractures.…”

Section: Discussionmentioning

confidence: 42%

Spinal Injuries in an Airplane Crash

Postma

Öner

Bijlsma

et al. 2015

Spine

Self Cite

View full text Add to dashboard Cite

show abstract

“…There have been some observational reports of the time needed for different imaging modalities in trauma patients. 10,20 Depending on the imaging methods and algorithms chosen, significant time reduction can be achieved for imaging examinations. Imaging during MCI patient work-up needs to be straightforward, robust and as comprehensive as possible.…”

Section: Capacity Issuesmentioning

confidence: 99%

“…Imaging utilization has been reported as high as 93% of victims in one study in the military setting of three explosive MCIs in Iraq in 2008 and 72% of victims in a large civilian airplane crash in 2009 in the Netherlands, exceeding numbers previously reported in literature. 9,10 Imaging providers must therefore be prepared to support treatment teams during DMP activation after MCIs. However, in the multinational, multi Level 1 trauma centre experience of the authors, radiology departments are underrepresented in-and in many cases excluded from-the DMPs of hospitals or associated drills.…”

Section: Introductionmentioning

confidence: 99%

Emergency imaging after a mass casualty incident: role of the radiology department during training for and activation of a disaster management plan

Berger¹,

Körner²,

Bernstein³

et al. 2016

BJR

View full text Add to dashboard Cite

In the setting of mass casualty incidents (MCIs), hospitals need to divert from normal routine to delivering the best possible care to the largest number of victims. This should be accomplished by activating an established hospital disaster management plan (DMP) known to all staff through prior training drills. Over the recent decades, imaging has increasingly been used to evaluate critically ill patients. It can also be used to increase the accuracy of triaging MCI victims, since overtriage (falsely higher triage category) and undertriage (falsely lower triage category) can severely impact resource availability and mortality rates, respectively. This article emphasizes the importance of including the radiology department in hospital preparations for a MCI and highlights factors expected to influence performance during hospital DMP activation including issues pertinent to effective simulation, such as establishing proper learning objectives. After-action reviews including performance evaluation and debriefing on issues are invaluable following simulation drills and DMP activation, in order to improve subsequent preparedness. Historically, most hospital DMPs have not adequately included radiology department operations, and they have not or to a little extent been integrated in the DMP activation simulation. This article aims to increase awareness of the need for radiology department engagement in order to increase radiology department preparedness for DMP activation after a MCI occurs.

show abstract

Radiological work-up after mass casualty incidents: are ATLS guidelines applicable?

Cited by 11 publications

References 25 publications

Comparison of whole-body computed tomography vs selective radiological imaging on outcomes in major trauma patients: a meta-analysis

Comparison of whole-body computed tomography vs selective radiological imaging on outcomes in major trauma patients: a meta-analysis

Spinal Injuries in an Airplane Crash

Emergency imaging after a mass casualty incident: role of the radiology department during training for and activation of a disaster management plan

Contact Info

Product

Resources

About