CT Trauma (Pan-Scan)
Whole-body CT protocol for blunt polytrauma — non-contrast head, CT angiogram of neck, contrast-enhanced chest/abdomen/pelvis in a single patient encounter. ED-adjacent or in-ED CT scanner is the bottleneck; sub-minute acquisition on modern systems makes pan-scan feasible even for unstable patients. Whole-body CT in stable blunt trauma reduces missed injury and has been shown to reduce mortality in Tier 1 trauma populations.
Clinical pathway
- Primary survey + resuscitation in trauma bay; activate CT when stable.
- Transfer to CT with appropriate monitoring.
- Non-contrast head CT — intracranial hemorrhage, mass effect, fractures.
- Neck CTA — arterial phase.
- Chest/abdomen/pelvis — portal venous phase (sometimes split-bolus or multiphase).
- Delayed imaging as indicated — urinary tract, active extravasation.
- Reformats — sagittal/coronal spine, 3D pelvis.
Typical systems
- Siemens SOMATOM Force (dual-source, sub-second)
- GE Revolution CT (16-cm z-coverage)
- Canon Aquilion ONE (16-cm z-coverage)
Wide z-coverage scanners complete chest/abdomen/pelvis in 2–3 seconds and are preferred in Level 1 centers.
Room + procedure characteristics
- Scan time in room: 5–10 min including positioning and contrast
- Dose: 15–25 mSv typical for full pan-scan; optimized with iterative reconstruction and kV/mA adjustment
- Team: ED team + CT tech + radiologist at workstation