RC 414 - Modern imaging of major trauma
1. To appreciate the role of forensic radiology in a disaster victim identification process.
2. To learn about the methods using forensic radiology in a disaster victim identification process.
3. To discuss added value of forensic radiology in a disaster victim identification process.
Radiology, mainly as a tool for forensic odontology, has long been an essential discipline in the post-mortem identification of human remains. Because forensic radiology is a rapidly developing field due to the fast technical developments of CT scanners, the possible applications are increasing. A whole body CT scan contains a wealth of identification information that can be used in an identification process. This presentation will highlight the contribution of forensic radiology, and more specific a whole body CT scan, for a DVI-process, discussing its applications, equipment, advantages and positioning within a DVI-process. It will also discuss future developments, opportunities and challenges which future DVI-processes will face.
B. Conventional radiography in major trauma: role, technique modification and impact on interpretation
1. To appreciate the limited role of conventional radiography in major trauma.
2. To learn key radiographic indicators and signs of major trauma.
3. To discuss the impact of technique modification on anatomical appearances and the accurate identification of trauma on conventional radiographs.
The role of imaging in major trauma is to inform life-saving medical intervention and assist in the prioritization of patient care pathways. The modality of choice to undertake this is CT. However, what happens when cross-sectional imaging is not available due to equipment malfunction, planned service or lack of availability locally? In these situations, image referrals may revert back to conventional radiographic imaging. But with so little opportunity to undertake these examinations in the modern trauma setting, the radiographic skills and decision-making necessary to produce diagnostic images may be limited. This talk revisits the acquisition of chest and pelvis radiographs following major trauma and, through a series of case studies, provides an overview of important diagnostic features and explores the impact that radiographic technique may have on these.
1. To appreciate the role ultrasound can play in assessing the trauma patient, both in the hospital and ambulance setting.
2. To learn about focused assessment with sonography for trauma (FAST) and what training is required to perform FAST scanning.
3. To discuss the expanding role of ultrasound in the accident and emergency room. Who does what and when and how does it impact on patient care?
Ultrasound is the most widely used and readily available imaging modality in the world. In recent years, ultrasound has moved from its classic use in the radiology department to playing a useful and sometimes vital role in the assessment and management of the trauma patient. Focused assessment with sonography for trauma (FAST), chest abdominal-focused assessment sonography for trauma (CA-FAST) and extended-FAST (E-FAST) are now widely performed in cases of both penetrating and non-penetrating trauma. Despite this, more research needs to be done to elicit the affect ultrasound has on patient prognosis and survival. As ultrasound is portable it can be used both in the hospital and ambulance setting. FAST is now an integral part of the training of emergency physicians; however, there is a lack of standardisation around education and clinical competencies and there are also variations in the use of FAST between centres. While ultrasound on trauma patients is primarily performed by physicians, some countries are now training and using paramedics to perform ultrasound in the field and in ambulances before the patient is moved/arrives at the hospital. Ultrasound is extremely operator dependent and so anyone using ultrasound to assess patients must be properly trained and understand the advantages and limitations of ultrasound scanning. As ultrasound machines become cheaper and more accessible ultrasound is being used more and more in the emergency setting.