The use of whole-body CT for trauma patients: survey of UK emergency departments.

INTRODUCTION

Whole-body computed tomography (WBCT) is advocated for use in some trauma patients presenting to the emergency department (ED). It is unclear how widespread the use of WBCT is in the UK and the best way to select patients for WBCT remains controversial. The aim of this study was to investigate the current use and nature of WBCT policies in ED in the UK.

METHODS

A postal questionnaire was devised and distributed to lead doctors of 245 ED in the UK in May 2010. Two further rounds of questionnaires were sent out in June and July to non-responders.

RESULTS

184/245 hospitals responded (75.1%). 41/184 (22.3%) ED had a WBCT policy. 43 (23.4%) further ED indicated that they used WBCT in certain cases, without a formal policy. Hospitals with a WBCT policy saw significantly more trauma cases than those that did not. Most hospitals with a WBCT policy used multiple criteria to decide which patients received WBCT, although there were variations in the timing of CT and in who could request it. Out-of-hours CT scans were less likely to be reported by a consultant radiologist, and reporting times were longer.

DISCUSSION

The use of WBCT in the UK is variable, although centres that see more trauma seem more likely to have a WBCT policy. The results do raise concerns about how effectively WBCT can be delivered, especially out of hours, but nationwide plans to reorganise trauma care may potentially affect how and at which ED WBCT is offered in the future.