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Published in: Emergency Radiology 3/2007

01-07-2007 | Review Article

Advanced Trauma Life Support®. ABCDE from a radiological point of view

Authors: Digna R. Kool, Johan G. Blickman

Published in: Emergency Radiology | Issue 3/2007

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Abstract

Accidents are the primary cause of death in patients aged 45 years or younger. In many countries, Advanced Trauma Life Support® (ATLS®) is the foundation on which trauma care is based. We will summarize the principles and the radiological aspects of the ATLS®, and we will discuss discrepancies with day to day practice and the radiological literature. Because the ATLS® is neither thorough nor up-to-date concerning several parts of radiology in trauma, it should not be adopted without serious attention to defining the indications and limitations pertaining to diagnostic imaging.
Literature
1.
go back to reference American College of Surgeons Committee on Trauma (2004) Advanced trauma life support program for doctors, 7th edn. American College of Surgeons, Chicago American College of Surgeons Committee on Trauma (2004) Advanced trauma life support program for doctors, 7th edn. American College of Surgeons, Chicago
3.
go back to reference Khorasani R, Silverman SG, Meyer JE, Gibson M, Weissman BN, Seltzer SE (1994) Design and implementation of a new radiology consultation service in a teaching hospital. AJR Am J Roentgenol 163(2):457–459 (August)PubMed Khorasani R, Silverman SG, Meyer JE, Gibson M, Weissman BN, Seltzer SE (1994) Design and implementation of a new radiology consultation service in a teaching hospital. AJR Am J Roentgenol 163(2):457–459 (August)PubMed
4.
go back to reference Baker SR (1982) The operation of a radiology consultation service in an acute care hospital. JAMA 248(17):2152–2154 (November 5)PubMedCrossRef Baker SR (1982) The operation of a radiology consultation service in an acute care hospital. JAMA 248(17):2152–2154 (November 5)PubMedCrossRef
5.
go back to reference McCollough CH, Bruesewitz MR, Kofler JM Jr (2006) CT dose reduction and dose management tools: overview of available options. Radiographics 26(2):503–512 (March)PubMedCrossRef McCollough CH, Bruesewitz MR, Kofler JM Jr (2006) CT dose reduction and dose management tools: overview of available options. Radiographics 26(2):503–512 (March)PubMedCrossRef
6.
go back to reference Kalra MK, Rizzo SM, Novelline RA (2005) Reducing radiation dose in emergency computed tomography with automatic exposure control techniques. Emerg Radiol 11(5):267–274 (July)PubMedCrossRef Kalra MK, Rizzo SM, Novelline RA (2005) Reducing radiation dose in emergency computed tomography with automatic exposure control techniques. Emerg Radiol 11(5):267–274 (July)PubMedCrossRef
7.
8.
go back to reference Ball CG, Kirkpatrick AW, Fox DL, Laupland KB, Louis LJ, Andrews GD, Dunlop MP, Kortbeek JB, Nicolaou S (2006) Are occult pneumothoraces truly occult or simply missed? J Trauma 60(2):294–298 (February)PubMed Ball CG, Kirkpatrick AW, Fox DL, Laupland KB, Louis LJ, Andrews GD, Dunlop MP, Kortbeek JB, Nicolaou S (2006) Are occult pneumothoraces truly occult or simply missed? J Trauma 60(2):294–298 (February)PubMed
9.
go back to reference Lim KE, Tai SC, Chan CY, Hsu YY, Hsu WC, Lin BC, Lee KT (2005) Diagnosis of malpositioned chest tubes after emergency tube thoracostomy: is computed tomography more accurate than chest radiograph? Clin Imaging 29(6):401–405 (November)PubMedCrossRef Lim KE, Tai SC, Chan CY, Hsu YY, Hsu WC, Lin BC, Lee KT (2005) Diagnosis of malpositioned chest tubes after emergency tube thoracostomy: is computed tomography more accurate than chest radiograph? Clin Imaging 29(6):401–405 (November)PubMedCrossRef
10.
go back to reference McKenney M, Lentz K, Nunez D, Sosa JL, Sleeman D, Axelrad A, Martin L, Kirton O, Oldham C (1994) Can ultrasound replace diagnostic peritoneal lavage in the assessment of blunt trauma? J Trauma 37(3):439–441 (September)PubMed McKenney M, Lentz K, Nunez D, Sosa JL, Sleeman D, Axelrad A, Martin L, Kirton O, Oldham C (1994) Can ultrasound replace diagnostic peritoneal lavage in the assessment of blunt trauma? J Trauma 37(3):439–441 (September)PubMed
11.
go back to reference Farahmand N, Sirlin CB, Brown MA, Shragg GP, Fortlage D, Hoyt DB, Casola G (2005) Hypotensive patients with blunt abdominal trauma: performance of screening US. Radiology 235(2):436–443 (May)PubMedCrossRef Farahmand N, Sirlin CB, Brown MA, Shragg GP, Fortlage D, Hoyt DB, Casola G (2005) Hypotensive patients with blunt abdominal trauma: performance of screening US. Radiology 235(2):436–443 (May)PubMedCrossRef
12.
go back to reference Ptak T, Rhea JT, Noveline RA (2001) Experience with a continuous, single–pass whole-body multidetector CT protocol for trauma: the three-minute multiple trauma CT scan. Emerg Radiol 8:250–256CrossRef Ptak T, Rhea JT, Noveline RA (2001) Experience with a continuous, single–pass whole-body multidetector CT protocol for trauma: the three-minute multiple trauma CT scan. Emerg Radiol 8:250–256CrossRef
13.
go back to reference Killeen KL, Shanmuganathan K, Mirvis SE (2002) Imaging of traumatic diaphragmatic injuries. Semin Ultrasound CT MR 23(2):184–192 (April)PubMedCrossRef Killeen KL, Shanmuganathan K, Mirvis SE (2002) Imaging of traumatic diaphragmatic injuries. Semin Ultrasound CT MR 23(2):184–192 (April)PubMedCrossRef
14.
15.
go back to reference Larici AR, Gotway MB, Litt HI, Reddy GP, Webb WR, Gotway CA, Dawn SK, Marder SR, Storto ML (2002) Helical CT with sagittal and coronal reconstructions: accuracy for detection of diaphragmatic injury. AJR Am J Roentgenol 179(2):451–457 (August)PubMed Larici AR, Gotway MB, Litt HI, Reddy GP, Webb WR, Gotway CA, Dawn SK, Marder SR, Storto ML (2002) Helical CT with sagittal and coronal reconstructions: accuracy for detection of diaphragmatic injury. AJR Am J Roentgenol 179(2):451–457 (August)PubMed
16.
go back to reference Pryor JP, Braslow B, Reilly PM, Gullamondegi O, Hedrick JH, Schwab CW (2005) The evolving role of interventional radiology in trauma care. J Trauma 59(1):102–104 (July)PubMed Pryor JP, Braslow B, Reilly PM, Gullamondegi O, Hedrick JH, Schwab CW (2005) The evolving role of interventional radiology in trauma care. J Trauma 59(1):102–104 (July)PubMed
17.
go back to reference Dondelinger RF, Trotteur G, Ghaye B, Szapiro D (2002) Traumatic injuries: radiological hemostatic intervention at admission. Eur Radiol 12(5):979–993 (May)PubMedCrossRef Dondelinger RF, Trotteur G, Ghaye B, Szapiro D (2002) Traumatic injuries: radiological hemostatic intervention at admission. Eur Radiol 12(5):979–993 (May)PubMedCrossRef
18.
go back to reference Stewart BG, Rhea JT, Sheridan RL, Noveline RA (2002) Is the screening portable pelvis film clinically useful in multiple trauma patients who will be examined by abdominopelvic CT? Experience with 397 patients. Emerg Radiol 9:266–271PubMed Stewart BG, Rhea JT, Sheridan RL, Noveline RA (2002) Is the screening portable pelvis film clinically useful in multiple trauma patients who will be examined by abdominopelvic CT? Experience with 397 patients. Emerg Radiol 9:266–271PubMed
19.
go back to reference Leschka S, Alkadhi H, Boehm T, Marincek B, Wildermuth S (2005) Coronal ultra-thick multiplanar CT reconstructions (MPR) of the pelvis in the multiple trauma patient: an alternative for the initial conventional radiograph. Rofo 177(10):1405–1411 (October)PubMed Leschka S, Alkadhi H, Boehm T, Marincek B, Wildermuth S (2005) Coronal ultra-thick multiplanar CT reconstructions (MPR) of the pelvis in the multiple trauma patient: an alternative for the initial conventional radiograph. Rofo 177(10):1405–1411 (October)PubMed
20.
go back to reference Wedegartner U, Gatzka C, Rueger JM, Adam G (2003) Multislice CT (MSCT) in the detection and classification of pelvic and acetabular fractures. Rofo 175(1):105–111 (January)PubMed Wedegartner U, Gatzka C, Rueger JM, Adam G (2003) Multislice CT (MSCT) in the detection and classification of pelvic and acetabular fractures. Rofo 175(1):105–111 (January)PubMed
21.
go back to reference Corriere JN Jr, Sandler CM (2006) Diagnosis and management of bladder injuries. Urol Clin North Am 33(1):67–71, vi (February)PubMedCrossRef Corriere JN Jr, Sandler CM (2006) Diagnosis and management of bladder injuries. Urol Clin North Am 33(1):67–71, vi (February)PubMedCrossRef
22.
go back to reference American College of Surgeons Committee on trauma (1997) Advanced trauma life support for doctors, instructor course manual, 6th edn. American College of Surgeons, Chicago American College of Surgeons Committee on trauma (1997) Advanced trauma life support for doctors, instructor course manual, 6th edn. American College of Surgeons, Chicago
23.
go back to reference Stiell IG, Wells GA, Vandemheen KL, Clement CM, Lesiuk H, De Maio VJ, Laupacis A, Schull M, McKnight RD, Verbeek R, Brison R, Cass D, Dreyer J, Eisenhauer MA, Greenberg GH, MacPhail I, Morrison L, Reardon M, Worthington J (2001) The Canadian C-spine rule for radiography in alert and stable trauma patients. JAMA 286(15):1841–1848 (October 17)PubMedCrossRef Stiell IG, Wells GA, Vandemheen KL, Clement CM, Lesiuk H, De Maio VJ, Laupacis A, Schull M, McKnight RD, Verbeek R, Brison R, Cass D, Dreyer J, Eisenhauer MA, Greenberg GH, MacPhail I, Morrison L, Reardon M, Worthington J (2001) The Canadian C-spine rule for radiography in alert and stable trauma patients. JAMA 286(15):1841–1848 (October 17)PubMedCrossRef
24.
go back to reference Hoffman JR, Mower WR, Wolfson AB, Todd KH, Zucker MI, National Emergency X-Radiography Utilization Study Group (2000) Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. N Engl J Med 343(2):94–99 (July 13)PubMedCrossRef Hoffman JR, Mower WR, Wolfson AB, Todd KH, Zucker MI, National Emergency X-Radiography Utilization Study Group (2000) Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. N Engl J Med 343(2):94–99 (July 13)PubMedCrossRef
25.
go back to reference Panacek EA, Mower WR, Holmes JF, Hoffman JR (2001) Test performance of the individual NEXUS low-risk clinical screening criteria for cervical spine injury. Ann Emerg Med 38(1):22–25 (July)PubMedCrossRef Panacek EA, Mower WR, Holmes JF, Hoffman JR (2001) Test performance of the individual NEXUS low-risk clinical screening criteria for cervical spine injury. Ann Emerg Med 38(1):22–25 (July)PubMedCrossRef
26.
go back to reference Contractor N, Thomas M (2002) Towards evidence based emergency medicine: best BETs from Manchester Royal Infirmary. Swimmers view or supine oblique views to visualise the cervicothoracic junction. Emerg Med J 19(6):550–551 (November)PubMedCrossRef Contractor N, Thomas M (2002) Towards evidence based emergency medicine: best BETs from Manchester Royal Infirmary. Swimmers view or supine oblique views to visualise the cervicothoracic junction. Emerg Med J 19(6):550–551 (November)PubMedCrossRef
27.
go back to reference Hadley MN, Walters BC, Grabb PA, Oyesiku NM, Przybylski GJ, Resnick DK, Ryken TC (2002) Radiographic assessment of the cervical spine in symptomatic trauma patients. Neurosurgery 50(3 Suppl):S36–S43 (March) Hadley MN, Walters BC, Grabb PA, Oyesiku NM, Przybylski GJ, Resnick DK, Ryken TC (2002) Radiographic assessment of the cervical spine in symptomatic trauma patients. Neurosurgery 50(3 Suppl):S36–S43 (March)
28.
go back to reference Morris CG, Mullan B (2004) Clearing the cervical spine after polytrauma: implementing unified management for unconscious victims in the intensive care unit. Anaesthesia 59(8):755–761 (August)PubMedCrossRef Morris CG, Mullan B (2004) Clearing the cervical spine after polytrauma: implementing unified management for unconscious victims in the intensive care unit. Anaesthesia 59(8):755–761 (August)PubMedCrossRef
30.
go back to reference Beattie LK, Choi J (2006) Acute spinal injuries: assessment and management. Emerg Med Pract 8(5):1–28 Beattie LK, Choi J (2006) Acute spinal injuries: assessment and management. Emerg Med Pract 8(5):1–28
31.
go back to reference Smits M, Dippel DW, de Haan GG, Dekker HM, Vos PE, Kool DR, Nederkoorn PJ, Hofman PA, Twijnstra A, Tanghe HL, Hunink MG (2005) External validation of the Canadian CT head rule and the New Orleans criteria for CT scanning in patients with minor head injury. JAMA 294(12):1519–1525 (September 28)PubMedCrossRef Smits M, Dippel DW, de Haan GG, Dekker HM, Vos PE, Kool DR, Nederkoorn PJ, Hofman PA, Twijnstra A, Tanghe HL, Hunink MG (2005) External validation of the Canadian CT head rule and the New Orleans criteria for CT scanning in patients with minor head injury. JAMA 294(12):1519–1525 (September 28)PubMedCrossRef
32.
go back to reference Haydel MJ, Preston CA, Mills TJ, Luber S, Blaudeau E, DeBlieux PM (2000) Indications for computed tomography in patients with minor head injury. N Engl J Med 343(2):100–105 (July 13)PubMedCrossRef Haydel MJ, Preston CA, Mills TJ, Luber S, Blaudeau E, DeBlieux PM (2000) Indications for computed tomography in patients with minor head injury. N Engl J Med 343(2):100–105 (July 13)PubMedCrossRef
33.
go back to reference Stiell IG, Wells GA, Vandemheen K, Clement C, Lesiuk H, Laupacis A, McKnight RD, Verbeek R, Brison R, Cass D, Eisenhauer ME, Greenberg G, Worthington J (2001) The Canadian CT head rule for patients with minor head injury. Lancet 357(9266):1391–1396 (May 5)PubMedCrossRef Stiell IG, Wells GA, Vandemheen K, Clement C, Lesiuk H, Laupacis A, McKnight RD, Verbeek R, Brison R, Cass D, Eisenhauer ME, Greenberg G, Worthington J (2001) The Canadian CT head rule for patients with minor head injury. Lancet 357(9266):1391–1396 (May 5)PubMedCrossRef
34.
go back to reference Smits M, Dippel DW, Steyerberg EW, de Haan GG, Dekker HM, Vos PE, Kool DR, Nederkoorn PJ, Hofman PA, Twijnstra A, Tanghe HL, Hunink MG (2007) Predicting intracranial traumatic findings on computed tomography in patients with minor head injury: the CHIP prediction rule. Ann Intern Med 146(6):397–405 (March 20)PubMed Smits M, Dippel DW, Steyerberg EW, de Haan GG, Dekker HM, Vos PE, Kool DR, Nederkoorn PJ, Hofman PA, Twijnstra A, Tanghe HL, Hunink MG (2007) Predicting intracranial traumatic findings on computed tomography in patients with minor head injury: the CHIP prediction rule. Ann Intern Med 146(6):397–405 (March 20)PubMed
35.
go back to reference Inaba K, Munera F, McKenney M, Schulman C, de MM, Rivas L, Pearce A, Cohn S (2006) Visceral torso computed tomography for clearance of the thoracolumbar spine in trauma: a review of the literature. J Trauma 60(4):915–920 (April)PubMedCrossRef Inaba K, Munera F, McKenney M, Schulman C, de MM, Rivas L, Pearce A, Cohn S (2006) Visceral torso computed tomography for clearance of the thoracolumbar spine in trauma: a review of the literature. J Trauma 60(4):915–920 (April)PubMedCrossRef
36.
go back to reference Shanmuganathan K, Mirvis SE, Chiu WC, Killeen KL, Hogan GJ, Scalea TM (2004) Penetrating torso trauma: triple-contrast helical CT in peritoneal violation and organ injury—a prospective study in 200 patients. Radiology 231(3):775–784 (June)PubMedCrossRef Shanmuganathan K, Mirvis SE, Chiu WC, Killeen KL, Hogan GJ, Scalea TM (2004) Penetrating torso trauma: triple-contrast helical CT in peritoneal violation and organ injury—a prospective study in 200 patients. Radiology 231(3):775–784 (June)PubMedCrossRef
Metadata
Title
Advanced Trauma Life Support®. ABCDE from a radiological point of view
Authors
Digna R. Kool
Johan G. Blickman
Publication date
01-07-2007
Publisher
Springer-Verlag
Published in
Emergency Radiology / Issue 3/2007
Print ISSN: 1070-3004
Electronic ISSN: 1438-1435
DOI
https://doi.org/10.1007/s10140-007-0633-x

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