WHOLE BODY COMPUTED TOMOGRAPHY (CT PAN-SCAN), A PROPOSED GUIDELINE FOR ADULT MAJOR BLUNT TRAUMA PATIENTS IN MALAYSIA

Abstract

INTRODUCTION

This review and proposed guideline is created to assist in the development and implementation of a Whole Body Computed Tomography (WBCT) protocol for adult major blunt trauma victims attending tertiary medical centers and centers with the availability of CT-scans in Malaysia

DISCUSSION

The introduction of WBCT or CT-Pan Scan in trauma has evidently improved clinical outcomes globally by reducing morbidity and mortality rates. It provides rapid accurate diagnosis and reduces the risk of missing potentially life-threatening injuries. Integration of such intervention will reduce delay to time critical treatment and improve patient outcomes. WBCT should be performed only for selected high-risk patients. With focus on reducing risk versus benefit ratio and channeling resources to appropriate cohorts of patients, the WBCT should be performed with evidence based triage criteria’s that depict severe injuries and predict victims whom are at high risk of concealed life-threatening injuries. Protocol and indication thresholds may differ amongst institutions depending on the availability of resources and expertise. This proposed guideline may assist the proses of developing an effective protocol. It addresses confounding issues surrounding the use of WBCT and delineates the indication threshold and pre-set triage criteria’s including, mechanism of injury, anatomical and physiological parameters.

CONCLUSION

This proposed guideline addresses key issues and provides the basis for the development of an effective Whole Body Computed Tomography in trauma protocol for tertiary hospitals in Malaysia. This is a clinical trauma system improvement intervention, which incorporates CT-Imaging guidelines to facilitate rapid diagnosis and reduce potentially life threatening missed injuries in major trauma.