Bildgebung im Schockraum

Background

Successful emergency room management requires an interdisciplinary approach of a team of anesthesiologists, surgeons, and radiologists. Modern multidetector computed tomography (CT) scan systems have become the centerpiece in the radiological diagnosis and allow the body of multiply injured patients to be examined in the shortest possible time

Method

Research and analysis of the current literature.

Results and conclusions

Sonographic examination of the abdomen according to the FAST protocol (“focussed assessment with sonography for trauma”) has the main objective to detect free intra-abdominal fluid and remains of high relevance in the emergency room algorithm despite the outstanding sensitivity and specificity of CT diagnosis. Likewise, the conventional imaging of the chest and pelvis remains of high importance in the management concept of severely injured patients, mainly due to its rapid availability. Interventional radiology has become an integral part in the management of trauma patients and is mainly used in injury patterns such as pelvic fractures, vertebral body fractures or lacerations of large arterial vessels. In these instances, the main tool is a diagnostic angiography and, if required, subsequent embolization or stent implantation. The temporary balloon occlusion of the infrarenal abdominal aorta or the internal iliac artery is considered as the last therapeutic option in uncontrollable bleeding in pelvic ring fractures and lower extremity injuries.