"Trauma Mechanism" Alone is no Indication for Total-body CT-scan in Patients with no Injuries in Primary Survey

Introduction: In patients with trauma mechanism falling down >2meters or v-delta >30km/h, total-body CT-scan is widely performed for detection of missed injuries even if primary survey is not showing any. Aim of this study was to evaluate the injuries which can be detected in these patients using total-body CT-scan.

Methods: Patients who received total-body CT-scan for Trauma in the ER of a Level I-trauma center between January 2012 and November 2017 have been included in this retrospective, single-center study. CT-scans and patient´s records were evaluated.

Results and Discussion: 3976 patients could be included, 415 did not receive total-body CT-scan because of missing indication. In 342 patients with normal Primary survey, total-body CT-scan was performed. Not one missing injury could be diagnosed in these patients. Results of our study shows that trauma mechanism alone is not a reliable indication for total-body CT scan. There have not been any therapeutic consequence after performing the CT-scan. If the negative Primary Survey including clinical and radiological (ultrasound) examination was done properly, total-body CT-scan should not performed routinely in trauma patients.