BAT

[Trauma Doc]

Waiting 2 hours is not necessary and may be dangerous.  PO contrast adds
very little.  Water soluble contrast down the NGT or taken PO within a few
minutes of the scan is fine and may help identify a proximal duodenal
injury, if present.  As for waiting for a reading, that is also not
necessary and may be dangerous.  The high potential for rapid decompensation
always exists.  All CT imaging is read by us (trauma surgeons) as soon as
the images are available, which is generally before the patient is even off
the scanner.  A radiologist reviews the scans at a later time.  Although we
may miss tiny injuries (a thoracic transverse process fracture for example),
solid organ injury, free air, free fluid, pneumothoraces, and vascular
injuries (thoracic and abdominal) are easily identified even by the
neophyte.  Additionally, a brief look at brain CT imaging will easily
identify lesions that require emergent neugosurgical intervention.


>
> Today's Topics:
>
>   1. BAT (ccrone at charter.net)
>   2. Re: BAT (SJASMD at aol.com)
>   3. Re: BAT (Gad Shaked)
>   4. Re: BAT (Ronald Gross)
>
>
> ----------------------------------------------------------------------
>
> Message: 1
> Date: Mon, 24 Dec 2007 21:37:46 -0800
> From: <ccrone at charter.net>
> Subject: BAT
> To: trauma-list at trauma.org
> Message-ID: <20071225003746.SVITD.115026.root at fepweb13>
> Content-Type: text/plain; charset=utf-8
>
> I work at a small, rural ER (about 18, 000 annual ED volume).  We have no
> FAST/Ultrasound immediately available at all times.  If we have a case of
> blunt abdominal trauma & order a CT scan, our radiologist demands that we
> have the patient drink oral contrast & wait 2 hours for the CT to be
> performed.  It then takes another 30 minutes for the report to be
> obtained.    What do other institutions currently do regarding the use of
> oral contrast when obtaining abdominal/pelvic CT's for blunt abdominal
> trauma in a hemodynamically stable patient-- with suspected internal
> injuries?
>
> Thanks
>
>
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>