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  • Poster presentation
  • Open Access

Plain radiological investigations in admissions to a trauma centre ICU

  • 1 and
  • 1
Critical Care200812 (Suppl 2) :P347

https://doi.org/10.1186/cc6568

  • Published:

Keywords

  • Emergency Department
  • Cervical Spine
  • Trauma Patient
  • Trauma Centre
  • Spinal Injury

Introduction

As the tertiary centre in Northern Ireland, severely injured patients are transferred to Royal Victoria Hospital (RVH) regional ICU for further definitive management. Minimum radiology should be performed before transfer.

Methods

ICU transfers from the emergency department (ED), RVH and district general hospital (DGH), to the trauma centre were prospectively audited over 4 months.

Results

Thirteen patients were admitted from RVH ED, 25 from a DGH ED. Spinal injury was diagnosed in 7.7% in the RVH group versus 28% from the DGH ED. The median time to clear the cervical spine was 24 hours (RVH) versus 48 hours (DGH), and the thoracolumbars was 34 hours (RVH) versus 48 hours (DGH). See Tables 1 and 2.
Table 1

Plain radiological investigations performed

 

Chest (%)

Cervical spine lateral (%)

Cervical spine antero-posterior (%)

Thoracolumbar (%)

Pelvis (%)

RVH

100

100

100

53.8

38.5

DGH

96

88

88

68

32

Table 2

Injuries identified prior to ICU admission

 

Brain (%)

Cervical spine (%)

Thoracolumbar spine (%)

Chest (%)

RVH

53.8

0

0

38.5

DGH

76

8

8

28

Conclusion

Despite Advanced Trauma Life Support guidelines, plain X-ray scans of the lateral cervical spine, chest and pelvis are not routinely performed in all trauma patients. Not all spinal injuries are being detected by radiology performed in EDs. Significant delays in clearance of spinal injuries occur despite a protocol in place, exposing patients to other potential risks. The development of a critical care network in Northern Ireland should allow the standardisation of pre-ICU management of trauma patients.

Authors’ Affiliations

(1)
Royal Victoria Hospital, Belfast, UK

Copyright

© BioMed Central Ltd 2008

This article is published under license to BioMed Central Ltd.

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