Post-mortem computed tomography assessment of medical support device position following fatal trauma: a single-center experience. Emerg Radiol 2022 Oct;29(5):887-893
Date
06/29/2022Pubmed ID
35764902DOI
10.1007/s10140-022-02072-yScopus ID
2-s2.0-85132996970 (requires institutional sign-in at Scopus site) 3 CitationsAbstract
PURPOSE: To evaluate the percentage of misplaced medical support lines and tubes in deceased trauma patients using post-mortem computed tomography (PMCT).
METHODS: Over a 9-year period, trauma patients who died at or soon after arrival in the emergency department were candidates for inclusion. Whole body CT was performed without contrast with support medical devices left in place. Injury severity score (ISS) was calculated by the trauma registrar based on the injuries identified on PMCT. The location of support medical devices was documented in the finalized radiology reports.
RESULTS: A total of 87 decedents underwent PMCT, of which 69% (n = 60) were male. For ten decedents, the age was unknown. For the remaining 77 decedents, the average age was 48.4 years (range 18-96). The average ISS for the cohort was 43.4. Each decedent had an average of 3.3 support devices (2.9-3.6, 95% CI), of which an average of 1 (31.3%, 0.8-1.2, 95% CI) was malpositioned. A total of 60 (69.0%) had at least one malpositioned medical support device. The most commonly malpositioned devices were decompressive needle thoracostomies (n = 25/32, 78.1%). The least malpositioned devices were intraosseous catheters (n = 7/69, 10.1%). Nearly one quarter (n = 19/82, 23.2%) of mechanical airways were malpositioned, including 4.9% with esophageal intubation.
CONCLUSION: Malpositioned supportive medical devices are commonly identified on post-mortem computed tomography trauma decedents, seen in 69.0% of the cohort, including nearly one quarter with malpositioned mechanical airways. Post-mortem CT can serve as a useful adjunct in the quality improvement process by providing data for education of trauma and emergency physicians and first responders.
Author List
Hofer L, Corcoran B, Drahos AL, Levin JH, Steenburg SDAuthor
Jeremy H. Levin MD Assistant Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Autopsy
Emergency Service, Hospital
Female
Humans
Infusions, Intraosseous
Injury Severity Score
Male
Middle Aged
Tomography, X-Ray Computed
Young Adult
