Trauma Radiography

What is Trauma?

Trauma is defined as any physical damage to the body caused by a sudden, unexpected, dramatic, forceful, violent or accident event or fracture etc. In medical field trauma is known as “Physical Injuries”. The greek word “trauma” literally means “wound”. Trauma is the leading cause of death in the United States for persons of 1 to 34 years old. Suicide and homicide related cases are excluded in this statistic. Trauma, homicide and suicide rank 1st, 2nd and 3rd, respectively, as the leading causes of death in ages 15 to 24. Emergency medical care often is the difference between life and death when intentional and unintentional injuries occurs.

Common Radiography Trauma:

Blunt Trauma - a condition resulted from a blunt force from a mechanism and the surface of the skin remains intact. Examples are: Motor Vehicular Accidents (MVA), Collisions with pedestrians, falls, and aggravated assault.
Penetrating Trauma - a condition or injury in which the skin is pierced by an object and reaches in tissue of the body, resulted an open wound. Examples are: Gunshot wound, stab wounds, impalement injuries, and foreign body ingestion or aspiration.
trauma radiographyExplosive Trauma - it is also known as “blast injury”, this injury are caused by a direct or indirect exposure to an explosion and several mechanisms, including pressure shock wave, high velocity projectiles, and Burns. Burns may be caused by a number of agents including fire, steam and hot water, chemicals, electricity, and frostile.

Best Practices in Trauma Patients

A routine position is necessary to achieve the right radiographic images of the anatomy of interest. But radiography of the trauma patient is seldom allows the use of routine position and projections. Because these traumatized patient requires special attention to patient care techniques, while radiologic technologist performing difficult radiographic imaging procedures. Enumerated below are Technician’s best practices and provided with some universal guidelines for the trauma radiographer.

Speed - Trauma technician must take a quality radiograph in the shortest period of time. Performing Quick or rapid diagnostic examination is critical to saving the patients life.
Accuracy - Technician must provide an accurate images with a minimal amount of distortion and the maximum amount of recorded detail. Also, the central ray, the part, and the image receptor must be accurately placed and aligned it is also applies in trauma radiology. The use of shortest exposure time is important to minimize possibility of imaging involuntary and uncontrollable motion.
Quality - The quality of a radiograph does not have to sacrifice to produce an image quickly. The patient’s condition is not an excuse for a careless positioning and not providing more high quality radiographic images.
Positioning - Careful precaution for a trauma radiographer must be taken to ensure the performance of the radiographic imaging technique does not worsen the patient condition or injuries. The two projections at the right angles from one another ( the “golden rule” of technicians) still applies. As often as possible, move the tube and IR, rather than the patient, to obtain the desired projections.
Practice Standard Precautions - Blood and body fluids should be expected scene in trauma radiography. Gloves, mask, and gown must be properly worn by the technician. Protect the IR and sponges from body fluids by placing it on a nonporous plastic before an xray exam and keep all equipment and accessory devices clean and ready for use. Wash hand frequently, especially between patients.
Immobilization - Never remove any immobilization device without physician’s order. Provide proper immobilization and support to increase patient comfort and minimize risk of motion.
Anticipation - Anticipating required special projections or diagnostic procedure for certain injuries makes the radiographer a vital part of the emergency room (ER) team. Ex. If patients requiring an xray of the chest. Fractures of the pelvis is often require a cystogram to determine the status of the urinary bladder. Being preferred to perform these examination quickly and understanding the necessity of these additional images instills confidence in, and creates an appreciation for, the role of the radiologic technologist in the emergency setting.
Attention to Detail - When performing an imaging procedure never leave the trauma patient or any patient unattended because the patient condition may change at any time, and its the radiographer’s responsibility to note these changes and report them immediately to the attending physician. During film processing, an eye contact with your patients is impossible, call for help. Someone must be with the trauma patient at all times.
Attention to Department Protocol and Scope of Practice - Radiographer must know the department protocols and practice only within your competence and abilities. This scope of practice for radiologic technicians varies from state to state and country by country. Understand and study the scope of your role in the emergency setting. Do not provide or offer a patient anything by mouth. Always ask the attending physician before giving the patient anything to eat or drink no matter how persistent the patient may be.
Professionalism - Ethical conduct and professionalism in all situations and with every person is a requirement of all health care professionals, but the conditions encountered in the emergency room can particularly complicated. Adhere to Code of Ethics for Radiologic Technologist and the Practice Standards. Be aware of the people present or nearby at all times when discussing a patient’s care. The ER radiologic technician is exposed to a myriad of tragic conditions. Emotional reactions are common and expected, but must be controlled until the emergency care of the patient is complete.

Common Traumatic Conditions

Hypovolemic or hemorrhagic shock
Is a medical condition where there are abnormally low levels of blood plasma in the body, in this such situation, the body is unable to properly maintain blood pressure, cardiac output of blood and normal amounts of fluid in the most common type of shock in trauma patients.

Symptoms of Hypovolemic or Hemorrhagic Shock

  • Diaphoresis,
  • Cool and dammy skin
  • Decrease in venous pressure
  • Decrease in urine output
  • Thirst
  • Altered state of consciousness

Vasovagal Reactions

Is also called a vasovagal attack or situational syncope, as well as vasovagal syncope. It is a reflex of the involuntary nevous system or a normal physiologic response to emotional stress.

Symptoms of Vasovagal Attack

  • The patient may complain of nausea
  • Feeling Flush (warm feeling)
  • Feeling Lightheaded
  • They may appear pale before they lose consciousness for several seconds.

Cerebrovascular Accident CVA

is commonly known and called a stroke and may be caused by thrombosis, embolism or hemorrhage in the vessels of the brain

Drugs and Alchohol

Patients under the influence of drugs and or alchohol are common patients in the ER. In this situation, the usual symptoms of shock and head injury are unreliable. Be on guard for aggressive physical behaviors and abusive language.


is also commonly known as diabetic ketaacidosis. The cause is increased blood sugar levels. The patient may exhibit any combination of symptoms noted, and will have fruity-smelling breath.

Pelvic Fracture

it has a high mortality rate of all open fractures and are as high as 50%. Hemorrhage and shock are very often associated with this type of injury. Emergency cystograms are often ordered on patients with known pelvic fractures.