Synopsis
Choose trauma imaging according to physiology, mechanism and patient group, obtain actionable studies without delaying resuscitation, and convert every result into an owned treatment decision.
- Settle the destination during the primary survey: unstable non-responder to haemorrhage control, suitable responder to CT, and isolated stable injury to selective imaging.
- For adults with blunt major trauma and suspected multiple injuries, NICE recommends immediate whole-body CT from vertex to mid-thigh without repositioning during acquisition.
- Do not routinely use whole-body CT in children; image the body regions indicated by clinical assessment, using paediatric protocols and senior radiology input.
Key red flags
Persistent or recurrent shock despite blood, active external loss or a clinical chest emergency makes routine transport to CT unsafe unless imaging occurs within a fully capable resuscitation environment.
Investigation priorities
Define multisystem blunt injury in one coordinated acquisition.
Evaluate a stable suspected isolated fracture or joint injury.
Management branches
The primary survey identifies possible major injury requiring imaging or immediate control.
- Treat airway obstruction, tension pneumothorax and external catastrophic bleeding first, start blood resuscitation and assess response over time.
- For persistent non-response, use clinical and focused bedside findings to choose operative, endovascular or hybrid source control without routine CT delay.