Whole body computed tomography for trauma: friend or foe?

Whole body CT (WBCT) is now an accepted practice in the primary management of the major trauma patient, but there remains a notable absence of a universal clinical decision tool for patient selection in any country. In the UK, The Royal College of Radiologists advises that a polytrauma protocol Multi-Detector Computed Tomography (MDCT) is indicated when there is haemodynamic instability, the mechanism of injury or presentation suggests that there may be occult severe injuries that cannot be excluded by clinical examination or plain films, plain films or Focussed Assessment with Songraphy for Trauma (FAST) suggest significant injury or there is obvious severe injury on clinical assessment.1 The 2016 National Institute for Health and Care Excellence Major Trauma Guidelines also broadly recommended to use WBCT in patients with 'blunt major trauma and suspected multiple injuries'.2

Trauma team leaders must use their clinical judgement to weigh up the potential benefits of detecting...

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