Emergency department imaging: current practice.

Purpose: To provide a snapshot of the demographics of radiologists providing coverage for emergency departments (EDs) and current imaging practices in EDs in the United States.

Methods: An online survey was created with Views Flash 3 software (Cogix, Monterey, California). Random e-mail addresses from a variety of databases were chosen. A total of 678 surveys were sent over a 9-month period.

Results: One hundred ninety-two radiology groups (28%) responded to the survey. Forty-one groups (21%) had designated emergency radiology divisions. Sixty-three groups (33%) were using computed tomographic (CT) coronary angiography in the ED workup of chest-pain. Thirty-five groups (18%) were using "triple-rule-out scans" (ie, a single CT scan to rule out coronary artery disease, pulmonary embolism, and aortic dissection). Multiplanar reconstructions of chest, abdominal, and pelvic CT images were routinely performed by 95 groups (49%). Forty-four percent used reformatted CT images instead of conventional radiographs in the workup of cervical spine trauma, and 68 groups (35%) used reformations in thoracic and lumbar spine trauma. Ninety groups (47%) did not use oral contrast for blunt abdominal trauma CT scanning. Sixty-seven respondents (35%) preferred computed tomography to evaluate for acute appendicitis in the setting of pregnancy. Forty percent of imaging equipment located within the EDs was CT scanners. The majority of the groups still communicated unexpected findings via telephone (49%).

Conclusion: New imaging practices for the evaluation of entities such as chest pain, spine trauma, and abdominal pain and trauma are emerging in EDs. As one plans ED development, these trends should be considered.