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Proposed algorithm for screening patients with blunt abdominal trauma. Hemodynamically unstable patients are initially screened with US. If US findings are positive and the patient can be stabilized, CT can be performed. If US findings are positive and the patient cannot be stabilized, exploratory laparotomy should be performed emergently. Hemodynamically stable patients with known or suspected hematuria and/or axial fracture should undergo CT directly, unless other clinical findings or logistical considerations mandate initial US. Patients with no known or suspected injury predictors can undergo screening US first. BAT = blunt abdominal trauma, OR = transport to operating room (eg, for exploratory laparotomy), IR = transport to interventional radiology (eg, for transarterial embolization).
