B-type natriuretic peptide levels may be elevated in the critically injured trauma patient without congestive heart failure.

Background: Rapid diagnosis of congestive heart failure (CHF) is essential to treatment. B-type natriuretic peptide (BNP) is a neurohormone secreted by the heart in response to fluid overload and has been shown to be elevated in medical patients with left ventricular dysfunction. However, BNP has not been evaluated in the critically ill patient with trauma.

Magnetic resonance imaging is not needed to clear cervical spines in blunt trauma patients with normal computed tomographic results and no motor deficits.

Hypothesis: Trauma patients with normal motor examination results and normal cervical spine helical computed tomographic (CT) scans with sagittal reconstructions do not have significant cervical spine injury.

Design: Prospectively collected registry data.

Setting: Level II community-based trauma center.

Cervical spine clearance in blunt trauma: evaluation of a computed tomography-based protocol.

Background: Prompt identification of cervical spine injuries has been a critical issue in trauma management. In 1998, the authors developed a new protocol to evaluate cervical spines in blunt trauma. This protocol relies on clinical clearance for appropriate patients and helical computed tomography instead of plain radiographs for patients who cannot be clinically cleared.