Case: RIPIT to the Rescue – Fast CT Examination for Trauma Patients

History
A 70-year-old female was involved in a high-speed motor vehicle collision. An auto launch was triggered immediately and the patient was transferred by helicopter to Vancouver General Hospital (VGH). Immediate imaging was required to quickly ascertain the patient’s condition. A RIPIT FLASH was performed (Rapid Imaging Protocol In Trauma).

Diagnosis
The brain demonstrated subarachnoid hemorrhage and small hemorrhagic contusion. A complex LEFORT TYPE 3 VARIANT facial fracture was identified instantaneously. The globes were intact. In addition there was ground glass density in both lower lobes with centrilobular nodular tree in bud appearance, signifying aspiration of blood. The abdomen was normal.

Comments
Given the age and frailty of the patient, an immediate assessment of the patient’s condition was required and this was provided in a matter of seconds with the FLASH RIPIT protocol. The brain findings were not surgical and the complex facial fracture was quickly repaired. The lung findings ensured that the patient was observed with diligence, as this could lead to Acute Respiratory Distress Syndrome (ARDS). In the trauma setting, the “golden hour” is critical. If appropriate therapy is instituted then, this can have an important impact on improving patient outcomes by decreasing morbidity and mortality. The FLASH RIPIT scan can provide critical, life-saving information in a matter of seconds.

Table 1: Examination protocol

This case was first published on Somatom Sessions online.