Methods: Our Pediatric Level 2 Trauma Center (TC) implemented a CT scan practice guideline for pediatric trauma patients in March 2014. The guideline recommended for or against CT of the head and abdomen/pelvis using published criteria from the Pediatric Emergency Care and Research Network. There was no chest CT guideline. If a brain CT scan has been performed, its result must be normal. The terms mild traumatic brain injury and concussion may be used interchangeably. Recommendations Level 1 There are no level 1 recommendations Level 2 Clinicians should perform brain CT scan on patients that present with suspected brain injury in the acute setting if it is available. For initial imaging of patients with subacute or chronic head trauma and an unexplained cognitive or neurologic deficit, noncontrast brain MRI or noncontrast head CT is usually appropriate; these procedures are equivalent alternatives, and only one need be ordered in this setting. For patients with head trauma and suspected intracranial a noncontrast head ct should be considered in head trauma patients with no loss of consciousness or posttraumatic amnesia if there is a focal neurologic deficit, vomiting, severe headache, age 65 years or greater, physical signs of a basilar skull fracture, gcs score less than 15, coagulopathy, or a dangerous mechanism of injury.* *dangerous … Any critical trauma patient must be very carefully monitored and attended while in the CT scanner. Definite indications for CT scanning are: 4 GCS under 9 after resuscitation. Neurological deterioration such as two or more points on the GCS; hemiparesis. Drowsiness or confusion (GCS 9-13 persisting > 2 hours). Persistent headache, vomiting. This guideline provides recommendations for determining which patients with a known or suspected mild TBI require a head CT and which may be safely discharged. Here are a few important points to note: There is no evidence to recommend the use of a head MRI over a CT in acute evaluation. A noncontrast head CT is indicated in head trauma CT Whole Body There is limited literature to support the use of WBCT in patients who are hemodynamically unstable [6,7]. Patients who remain hemodynamically unstable despite initial attempts at resuscitation and who have positive signs for abdominal trauma (eg, a positive FAST) should proceed directly to exploratory laparotomy, with CT imaging Clinical information on the radiology requests should satisfy at least one criteria for polytrauma CT as recommended by the Royal College of Radiologists in 'Standards of practice and guidance for trauma radiology in severely injured patients, 2nd edition'. The acceptable criteria are as follows: - There is haemodynamic instability The guideline gives clinicians easy access to the essentials of the most recently revised clinical policy when they need it fast. This is especially important for clinicians working in acute care settings such as emergency departments. Clinicians can also access guidelines at their fingertips by using the accompanying pocket card, which Patients should not be repositioned during whole‑body CT. 1.5.35 Use clinical findings and the scanogram to direct CT of the limbs in adults (16 or over) with limb trauma. 1.5.36 Do not routinely use whole‑body CT to image children (under 16s). Use clinical judgement to limit CT to the body areas where assessment is needed. Damage control surgery The Canadian CT head rule (CCTHR) is a validated clinical decision rule to determine the