European Society of Emergency Radiology: guideline on radiological polytrauma imaging and service (short version)

Abstract
Background: Although some national recommendations for the role of radiology in a polytrauma service exist, there
are no European guidelines to date. Additionally, for many interdisciplinary guidelines, radiology tends to be underrepresented.
These factors motivated the European Society of Emergency Radiology (ESER) to develop radiologicallycentred
polytrauma guidelines.
Results: Evidence-based decisions were made on 68 individual aspects of polytrauma imaging at two ESER consensus
conferences. For severely injured patients, whole-body CT (WBCT) has been shown to significantly reduce mortality
when compared to targeted, selective CT. However, this advantage must be balanced against the radiation risk of
performing more WBCTs, especially in less severely injured patients. For this reason, we recommend a second lower
dose WBCT protocol as an alternative in certain clinical scenarios. The ESER Guideline on Radiological Polytrauma
Imaging and Service is published in two versions: a full version (download from the ESER homepage, https ://www.
eser-socie ty.org) and a short version also covering all recommendations (this article).
Conclusions: Once a patient has been accurately classified as polytrauma, each institution should be able to choose
from at least two WBCT protocols. One protocol should be optimised regarding time and precision, and is already
used by most institutions (variant A). The second protocol should be dose reduced and used for clinically stable and
oriented patients who nonetheless require a CT because the history suggests possible serious injury (variant B). Reading,
interpretation and communication of the report should be structured clinically following the ABCDE format, i.e.
diagnose first what kills firs