The Surge: Surgery. Trauma. Critical Care
Health & Fitness:Medicine
....or an argument against throwing the baby out with bathwater. Invariably we've all heard it on the podcasts, blogs and at the conferences. The reasons why we shouldn't do panscans are all over the internet. From conspiracy theories that radiologists and hospital admins are doing it for the money to the argument that it dulls clinical accumen.
IMHO panscans are a product of technology moving too fast for the literature. We keep asking questions like we did in 1999 when we're seeing the technology of 2017.
The question shouldn't be do panscans influence outcome or "flow" in the ED. The question should be: "In which patients has focused history, examination and selective CT scanning failed us?"
By and large the studies on which we've based our arguements against panscans are based on older CT scanners, retrospective data and radiation "risk" that is miniscule compared to the risk of missed injuries. You cannot use retrospective studies in which hemodynamically unstable patients are taken for a CT in 2000 (17 years ago) to make a point that panscans are evil. You can however say "just because the microwave is there doesn't mean we have to use it every day" . Like your microwave your panscan should have indications for use (never try and make pancakes in a microwave BTW), the trouble is we haven't figured them out yet.
Some alternative points of view that are probably more valid than mine :
ALIEM Top ten trasons not to Panscan.
Life in the Fast Lane Brief review .
Trauma.co.nz , The Debate:Panscan.
Episode 64: Preparing for Humanitarian Work and Deployment
Episode 63: Should we skip the ED Sometimes !?!?!?!
Episode 62: Crises of Confidence in Surgery.
Episode 61:WE ARE BACK!!!!!
Episode 60: Should you allow your patient to leave Against Medical Advice?
Episode 59:Peri-mortem Cesarians in Trauma Care
Episode 58: On Mental Health, Cyber Security and Blackmail
Episode 57:Never Let go of the F*****G Guidewire!
Episode 56: Full Throttle CPR
Episode 55:Skill Decay: Can you forget how to put in a Chest Tube after a year off?
Episode 54: Professionalism, Peer Review and the #Medbikini Movement
Episode 53: LMA Shower Thoughts
Episode 52: Psycho-Social and Spiritual Care in the ICU.
Episode 51: Vasopressor and Inotropes: White Belt to Black Belt Level Strategies
Episode 50: The Hippocratic Oath What does it Really Mean?
Episode 49: Head Trauma 2
Episode 48: Head Trauma 1
Episode 47: Penetrating hand injuries: Would you rather be bit by a Human, Dog , Cat or Avocado?
Episode 46: HAPPY HYPOXEMANIACS ..... Have we gone too far with Happy Hypoxemia?!?!
EPISODE 45:OUR FIRST GUEST HOSTS REAL LIFE NECK INJURIES WITH BOARD RESIDENTS!!!!!
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