Tag Archives: protocol

Blunt Trauma Radiographic Imaging Protocol

Last year, we developed an evidence-based protocol for deciding what radiographic images to order in our blunt trauma patients. For some body regions, there is fairly good literature available for guidance (i.e. Canadian head and cervical spine rules). For other areas, there is not nearly as much.

We convened a small group of people, including trauma surgeons, emergency physicians, radiologists and a radiation physicist to combine the information into a practical tool. 

You can view or download the worksheet we use by clicking the link at the bottom of this post. The protocol has been in use for about 9 months, and has significantly decreased the use of higher radiation dose imaging (CT). As a result, there has been a small increase in the use of lower dose conventional imaging (plain spine studies), but no missed injuries. 

Tomorrow, I’ll write about the specifics of how this protocol has changed our ordering habits. Click here to view it.

Click here to download the Blunt Trauma Radiographic Imaging Protocol Worksheet

Click here to download a bibliography of the literature used to develop the protocol

Algorithm For Clearing the Pediatric Cervical Spine

I previously wrote about a straightforward way to clear the cervical spine in children. Click here to see the article. Alfred I. DuPont Children’s Hospital has condensed their clearance technique into a relatively simple algorithm that can be used in conjunction with my previous tips.

Some notes on this algorithm:

  • Can be performed only by attending physicians or a trauma resident in consultation with the attending trauma surgeon
  • Clinical clearance alone may be carried out in select cases
  • If radiographs are required, cross-table lateral, anterior/posterior, and odontoid views should be obtained (age 8 and above, non-intubated)
  • Flexion / extension views should only be ordered in consultation with neurosurgery

Download a print version of the protocol here

Related post: How Do I Clear The Pediatric Cervical Spine?

Image and protocol courtesy of the Alfred I DuPont Children’s Hospital