0:00

Oftentimes in the ED, patients are traumatized and you'll come in or will

0:04

be asked to evaluate patients who have a history of trauma,

0:07

you may get very broad categorical, this is a patient who has had

0:11

trauma versus someone who has an NBC or who has had chest trauma,

0:15

or who's got penetrating trauma. So the degree of information that you get

0:18

is widely variable, but things to think about and to look for include

0:24

pneumo thoraxes, fractures pulmonary contusions. Whether or not there's

0:27

any aortic or great vessel injury, any sort of pericardial effusion or fluid

0:33

esophageal injury or bronchial injury. When you're thinking about exams

0:38

that can be ordered in this context, depending on your institution,

0:42

the ED may do the mass exams, some of the imaging teams

0:47

could be involved in mass exams, but we rely heavily on radiographs, both

0:51

PA and lateral, laterally if possible... And chest CTs. And then

0:56

in some instances, radiography of the ribs looking specifically for rib

1:01

fractures that may not be apparent on normal PA and lateral views of

1:06

the chest. So one thing to keep in mind, and I'm not a

1:08

huge fan of dedicated group series, particularly for getting other imaging,

1:13

as part of the work up. So if we know that we are getting

1:15

the CT, if we're gonna get a PA, and lateral of the chest

1:19

to radiograph with good inspiratory volume, again, the fractures that are

1:22

going to be damaging and need to be found right away,

1:26

generally you can see those, but keep in mind that oblique view that

1:28

are done on the rib series to elongate ribs and allow for a

1:33

better assessment of rib fractures.