The role of the emergency radiologist is essential to choose the best protocol for each patient according to the mechanism of injury and clinical information.
“The computed tomography (TC) obtains images of the whole body in seconds and allows the early diagnosis of injuries that can compromise the life of the patient in emergency“, as the emergency room radiologist points out, Elena Martinez Chamorrowest of 36th Congress of the Spanish Society of Medical Radiology (SERAM).
On the occasion of the International Day of Emergency and Emergency Medicine, which is celebrated this Friday, SERAM wants to make visible that the traumatic illness is the leading cause of death in young patientsunder 45 years of age and the fifth cause of general mortalityand what is more relevant, that it is an important cause of lost years of life and quality of life, which is how the impact of diseases is now measured.
Therefore, the role of the emergency radiologist is essential for choose the best protocol for each patient according to the injury mechanism and the clinical information, since the radiological diagnosis guides the management of the polytraumatized patient because he is the one who has a complete and comprehensive vision of all the injuries.
The computed tomography (TC) for its speed and great precision allows to evaluate in a single exploration all the structures of the body (head, neck, chest, abdomen, spine and limbs if necessary). For this reason, it is the technique of choice to identify hemorrhage, which remains the main cause of preventable death in polytraumatized patients if it is not controlled quickly. And, in addition, it allows reconstructions to be made in any plane of space, very useful in surgical planning.
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“A perfect integration between healthcare and diagnostic equipment is necessary” |
“Las imaging tests used in polytraumatized patients vary depending on their severity or hemodynamic stability. Keep in mind that in most severe cases it is necessary to maintain support and treatment while imaging tests are performed. That necessitates a perfect integration between healthcare and diagnostic equipment”, points out Martínez Chamorro.
The emergency radiologist, involved in the multidisciplinary team
The emergency radiologist is involved with the rest of the multidisciplinary team that attends to the polytraumatized patient in the development of protocols, participation in multidisciplinary sessions and being one more part of the medical team. The most frequent cause of polytraumatisms is traffic accidents, but they have been decreasing and increasing other causes such as suicide attempts, work accidents and violence both in the domestic sphere and street violence.
In Spain, according to ICU Trauma Registry (RetraUCI), the most frequently injured body regions in blunt trauma are the head and neck (46 percent) followed by the chest (39 percent), while, in case of penetrating traumaare the thorax (33 percent), followed by the extremities (23 percent) and the abdomen (22 percent).
Martínez points out that “for the adequate polytrauma patient care well-organized referral centers are required, emergency radiology section and in particular, the CT roomit must be located as close as possible to the place where the patient is received to minimize displacement and the CT equipment must have at least 64 detectors, since very fast studies are required in a few seconds and that cover the entire patient”.
On the other hand, the interventional radiologist can treat lesions that were previously surgical with percutaneous techniques, with greater speed and precision and less morbidity and have a very important role in the control of hemorrhage by use endovascular techniques with different materials, such as covered stents, occlusion balloons and liquid and solid embolic agents, which allow conservative management in many patients who were previously surgical.
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