An Algorithm for Minimizing Pelvic X-Rays in Blunt Trauma

The current Advanced Trauma Life Support protocol recommends anteroposterior plain pelvic radiographs for blunt trauma patients. However, if patients are undergoing abdominal pelvic computed tomography (AP-CT), pelvic radiographs are less accurate and redundant. These authors developed an algorithm for obtaining pelvic radiographs and conducted a prospective observational study of its effects during a 6-month period at a single level I trauma center in California. The algorithm dictated that blunt trauma patients undergoing AP-CT would forgo pelvic radiographs unless systolic blood pressure was <90 mm Hg, hemoglobin was <8 mg/dL, hemoglobin fell >3 mg/dL in the emergency department (ED), and significant pelvic examination findings were pres…