Brighton and Sussex Medical School, BSMS Teaching Building, University of Sussex, Brighton BN1 9PX, UK.
Br J Radiol. 2010 Mar;83(987):257-60. doi: 10.1259/bjr/53146076. Epub 2009 Dec 17.
Previous work has questioned how plain films should be used when imaging the cervical spine of trauma patients. The authors wanted to identify whether the National Institute for Clinical Excellence (NICE) guidelines were being followed with respect to the imaging of patients presenting with cervical spine injury over a 1 year period. Data retrieved from the Electronic Digital Information Service (EDIS) computerised database records of all patients presenting with a triage code 1 or 2 between 1 September 2007 and 31 August 2008 were used to conduct a retrospective audit that identified multiply injured and intubated patients who did not undergo CT of the cervical spine and to highlight the use of plain films when the patient was to undergo CT of the head and cervical spine. A clinical record search identified 52 patients with a mean age of 32 years, of whom 73% were males, who had been admitted with multiple traumas and had undergone imaging of the cervical spine. Although no patient was intubated without undergoing CT of the cervical spine or head, seven patients had plain films when it was clear that they were to undergo CT. In conclusion, the audit emphasised the excellent work of emergency department and radiology staff in identifying and imaging multiple trauma patients, as all patients requiring CT of the cervical spine received this investigation. However, careful thought should be given to ordering plain films before CT, as some patients who clearly required CT of the cervical spine underwent unnecessary lateral plain films in the emergency department, delaying their progression to definitive care.
先前的工作对创伤患者颈椎成像时应如何使用平片提出了质疑。作者希望确定在过去一年中,患者因颈椎损伤就诊时,国家临床卓越研究所(NICE)的指南在成像方面是否得到了遵循。从 2007 年 9 月 1 日至 2008 年 8 月 31 日期间,通过电子数字信息服务(EDIS)计算机数据库记录检索到所有分诊代码为 1 或 2 的患者的数据,进行了一项回顾性审核,以确定未进行颈椎 CT 检查的多发性损伤和插管患者,并强调在患者要进行头部和颈椎 CT 检查时使用平片。临床记录搜索确定了 52 名平均年龄为 32 岁的患者,其中 73%为男性,他们因多处创伤入院并进行了颈椎成像。尽管没有患者在未进行颈椎或头部 CT 检查的情况下插管,但有 7 名患者在明确要进行 CT 检查时仅拍摄了平片。总之,该审核强调了急诊部门和放射科工作人员在识别和成像多发创伤患者方面的出色工作,因为所有需要进行颈椎 CT 检查的患者都接受了此项检查。然而,在进行 CT 检查之前,应仔细考虑是否需要拍摄平片,因为一些明显需要进行颈椎 CT 检查的患者在急诊室进行了不必要的侧位平片检查,从而延迟了他们进入确定性治疗的进程。