Efficiency of a Standardized Diagnostic Protocol in Trauma Management

Background:

The objective of this study was to evaluate the efficiency of a radiologic trauma protocol which was implemented to ensure swift and accurate diagnosis, reduce unnecessary hospitalization and detect parameters that will efficiently predict surgical findings.

Patients and Methods: 1,757 patients were included in this prospective study which was carried out over a 5-year period. All parameters, mechanisms of trauma and radiologic findings were recorded.

Results: A total of 472 patients could be discharged the same day. Positive findings in all radiologic modalities ranged between 3.9% and 50% when grouped by trauma scores.

Conclusions: Implementation of our protocol resulted in a reduced number of patients admitted for clinical observation. A nontrivial number of positive findings was detected in all separate RTS (Revised Trauma Score) GCS (Glasgow Coma Scale) and trauma mechanism groups, with an increase in positive findings for groups specified by deteriorating trauma scores. Due to the unreliability of physical examination, especially in nonresponsive patients, radiologic work-up remains an important tool in the assessment of trauma patients.