Schockraummanagement ohne konventionelle Radiographie? : Macht der Computertomograph die Röntgenröhre überflüssig?

Backround. In the Wuerzburg University level one trauma centre, mobile whole-body multislice computed tomography (MSCT) is used as the primary diagnostic tool in multiple trauma patients. A conventional X-ray unit is notavailable directly in the resuscitation room of the trauma suite. Three cases are reported to discuss whether state-of-the-art trauma management can be done without conventional radiography. Methods. In each of the three cases reported here, an emergency situation has occurred in which the emergency diagnosis of the chest with the CT-scan was found to be difficult or impossible. These specific situations are described and discussed for each case and a conclusion is given at the end of this paper. Results. Three scenarios were identified in which conventional radiological diagnostics seemed to be necessary in the emergency room despite the availability of the MSCT. One is the patient undergoing cardiopulmonary resuscitation, the second is the patient that deteriorates after CT-diagnostic is completed and the third is technical problems with the CT-scanner. Conclusion. Whole-body MSCT is not sufficient as the sole diagnostic tool in hemodynamically instable trauma patients requiring resuscitation and needs to be complemented by a conventional x-ray unit for emergency diagnosis of the chest.