Management of HSC: Role of CT vs Ultrasound
Early recognition of shock is a central component of management, and supportive resuscitation treatment is administered while simultaneously investigating a cause. Both CTand ultrasound (US) play important but distinct roles in the management of trauma patients who present to the emergency department. The signs of HSC are primarily described on CT,but, recently,UShas also been used at the bedside to accurately and quickly assess the patient who is hypovolemic [23,24].With advances in CT technology and decreased acquisition times, emergency department evaluation of trauma
patients by using CT has become common practice. An advantage of CT imaging vs US is the ability to identify
a constellation of HSC signs in patients who were hypovolemic that indicate severe injury and poor prognosis.
Importantly, it allows discrimination between hemorrhagic shock vs blunt injury to abdominal organs, thus dictating
treatment strategy because only the latter requires surgical if patients present early. Thus, CT evaluation is advantageous
in these cases because it facilitates an early diagnosis of shock, and allows initiation of treatment that would have
otherwise been overlooked.