Physician Gestalt Not Adequate to Avoid CT in Blunt Trauma Patients

The clinical judgment of senior trauma physicians regarding likelihood of injury prior to whole body computed tomography scan had inadequate sensitivity for the exclusion of serious injuries.

To determine the accuracy of clinical judgment for predicting serious injury, researchers at a level-1 trauma center conducted a prospective observational study of stable patients aged 15 years or older with suspected blunt trauma and a high-energy mechanism of injury.

Based on the history, physical exam, and bedside ultrasound, but before the whole body computed tomography (CT) scan, the attending physician judged the clinical likelihood of a significant lesion on the following scale: 0 = sure of the absence of a lesion; 1 = suspect the absence of a lesion; 2 = suspect the presence of a lesion; 3 = sure of the presence of a lesion.

Of 354 patients, 127 had at least one serious injury (abbreviated injury score ≥3) detected on CT scan. Clinica…

Reviewing Author

Richard L. Byyny, MD, MSc, FACEP

Disclosures

EquityZimmer; Aetna

Editorial BoardsAmerican College of Emergency Physicians Clinical Policies Committee

Richard L. Byyny, MD, MSc, FACEP

Disclosures

EquityZimmer; Aetna

Editorial BoardsAmerican College of Emergency Physicians Clinical Policies Committee

Physician Gestalt Not Adequate to Avoid CT in Blunt Trauma Patients

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Reviewing Author