Radiodiagnosis
Emergency Radiology
Emergency radiology for MBBS and NEET-PG: trauma FAST and whole-body CT, non-contrast CT in stroke and head injury, vascular emergencies and line checks, mapped to NMC code RD1.10.
MedNext Academy | 3 min read
Emergency Radiology
Emergency radiology for MBBS and NEET-PG: trauma FAST and whole-body CT, non-contrast CT in stroke and head injury, vascular emergencies and line checks, mapped to NMC code RD1.10.
This chapter describes the role of emergency radiology and its interaction with clinical departments in the acutely unwell and injured patient. It covers the trauma pathway from bedside ultrasound to whole-body CT, the imaging of the acute abdomen, stroke and vascular emergencies, and the confirmation of line and tube positions in critical care.
High-yield: Emergency Radiology
- Emergency imaging supports rapid decisions in trauma, the acute abdomen, acute stroke and the critically ill, working closely with clinical teams.
- The focused assessment with sonography in trauma looks for free fluid in the hepatorenal, splenorenal, pelvic and pericardial spaces at the bedside.
- A whole-body or trauma CT is the definitive investigation in the stable polytrauma patient to map injuries quickly.
- Non-contrast CT of the head is the first-line test in acute stroke and head injury to detect haemorrhage before treatment.
- An erect chest radiograph detects free gas under the diaphragm from a perforated viscus and confirms line and tube positions.
- A tension pneumothorax is a clinical emergency treated by immediate decompression before waiting for imaging confirmation.
- A widened mediastinum on a trauma chest film raises the suspicion of aortic injury, prompting CT angiography.
- CT angiography is the investigation of choice for suspected aortic dissection and for active haemorrhage, showing contrast extravasation.
- Pelvic radiographs and CT identify unstable pelvic fractures that can cause life-threatening haemorrhage.
- The cervical spine is assessed with CT in significant trauma, as plain radiographs may miss fractures.
- Imaging confirms the correct position of an endotracheal tube, central line and nasogastric tube, and detects complications of their placement.
- CT pulmonary angiography rapidly diagnoses pulmonary embolism in the acutely breathless patient.
- A portable chest radiograph is invaluable in the intensive care setting, though it is less sensitive than an erect film.
- Prompt communication of critical imaging findings to the clinical team is central to emergency radiology and patient safety.
Emergency imaging pathways
- **Trauma:** Bedside sonography for free fluid; whole-body CT in the stable patient.
- **Stroke and head injury:** Non-contrast CT head first to detect haemorrhage before treatment.
- **Vascular emergency:** CT angiography for aortic dissection and active bleeding.
- **Critical care:** Chest radiograph confirms line and tube positions and detects complications.
NMC competencies in this chapter
- **RD1.10:** Role of emergency radiology and interaction with clinical departments
Frequently Asked Questions
What is the FAST scan used for?
The focused assessment with sonography in trauma is a bedside ultrasound looking for free fluid in the hepatorenal, splenorenal, pelvic and pericardial spaces, helping decide on urgent surgery in the unstable trauma patient.
Why is non-contrast CT first in acute head injury?
It rapidly detects intracranial haemorrhage and fractures, which must be identified before treatment. It is fast and widely available, making it ideal in the emergency setting.
How is a suspected aortic injury imaged after trauma?
A widened mediastinum on the trauma chest radiograph raises suspicion, and CT angiography of the aorta is then performed to confirm or exclude injury and define its extent.
Why image line and tube positions in critical care?
A chest radiograph confirms that an endotracheal tube, central line or nasogastric tube is correctly sited and detects complications such as pneumothorax or misplacement before they cause harm.
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