A Protocol for Abdominopelvic CT in Blunt Trauma Patients

Researchers at a single trauma center evaluated the effect of an evidence-based institutional protocol for reducing use of computed tomography (CT) in patients with blunt abdominopelvic trauma. The protocol called for abdominal CT for patients with hypotension, altered mental status, signs of spinal cord injury, abdominal pain or signs of trauma, hard signs of chest or pelvic injury, long bone fracture, or gross hematuria. Patients with none of these findings or with no intra-abdominal injury seen on CT who were on Coumadin or had thrombocytopenia, cirrhosis, end-stage congestive heart failure, or end-stage renal disease were admitted for observation.

The analysis included roughly 7700 patients admitted during the 4.5 years before implementa…