US FAST Scan Chest Abdomen Pelvis The role of FAST is primarily one of triage regardless of extremity injuries; a positive FAST and signs of hemodynamic instability may lead to immediate surgical intervention rather than CT. Although US may be able to diagnose certain thoracic and abdominal injuries, its relatively lower specificity compared with CT does not make it a sufficient test to exclude injuries to these areas [5]. Radiography Extremity Single-view radiographs of the traumatized extremity take little time and are frequently included in this setting. Radiography Trauma Series Trauma series radiographs typically consist of portable radiographs of the chest and pelvis and/or cross table cervical spine. A portable AP chest radiograph helps screen for immediate life-threatening findings, such as tension pneumothorax and significant mediastinal injury, as well as confirms line placement [13]. A portable radiograph of the pelvis can evaluate for unstable pelvic injuries and hip dislocation [4]. Radiographs of the suspected injured extremity are the first-line examination to be obtained. Variant 5: Major blunt trauma. Hemodynamically stable. Suspected bowel trauma. Initial imaging. CT Abdomen and Pelvis For blunt trauma, CT of the abdomen and pelvis with IV contrast is recommended, in the portal venous phase 70 seconds after contrast administration, for ideal characterization of solid organ injury. This may be obtained in conjunction with arterial phase images as well as delayed imaging of the abdomen and pelvis. The administration of oral contrast material has not been found to alter the sensitivity or specificity for blunt abdominal injuries and is not recommended because it can delay definitive diagnosis of other injuries [25]. Noncontrast CT of the abdomen and pelvis should ideally be avoided when possible because of its lower sensitivity for detecting both visceral organ and vascular injuries [19].
Major Blunt Trauma. US FAST Scan Chest Abdomen Pelvis The role of FAST is primarily one of triage regardless of extremity injuries; a positive FAST and signs of hemodynamic instability may lead to immediate surgical intervention rather than CT. Although US may be able to diagnose certain thoracic and abdominal injuries, its relatively lower specificity compared with CT does not make it a sufficient test to exclude injuries to these areas [5]. Radiography Extremity Single-view radiographs of the traumatized extremity take little time and are frequently included in this setting. Radiography Trauma Series Trauma series radiographs typically consist of portable radiographs of the chest and pelvis and/or cross table cervical spine. A portable AP chest radiograph helps screen for immediate life-threatening findings, such as tension pneumothorax and significant mediastinal injury, as well as confirms line placement [13]. A portable radiograph of the pelvis can evaluate for unstable pelvic injuries and hip dislocation [4]. Radiographs of the suspected injured extremity are the first-line examination to be obtained. Variant 5: Major blunt trauma. Hemodynamically stable. Suspected bowel trauma. Initial imaging. CT Abdomen and Pelvis For blunt trauma, CT of the abdomen and pelvis with IV contrast is recommended, in the portal venous phase 70 seconds after contrast administration, for ideal characterization of solid organ injury. This may be obtained in conjunction with arterial phase images as well as delayed imaging of the abdomen and pelvis. The administration of oral contrast material has not been found to alter the sensitivity or specificity for blunt abdominal injuries and is not recommended because it can delay definitive diagnosis of other injuries [25]. Noncontrast CT of the abdomen and pelvis should ideally be avoided when possible because of its lower sensitivity for detecting both visceral organ and vascular injuries [19].