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Introduction: Trauma

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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better assessment of rib fractures.

Report

Faculty

Jamlik-Omari Johnson, MD, FASER

Chair, Department of Radiology

University of Southern California

Tags

X-Ray (Plain Films)

Trauma

Lungs

Emergency

Chest

CT

Bone & Soft Tissues

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