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Table 2 Checkpoints for the interpretation of each region and definitions

From: Establishment and implementation of an effective rule for the interpretation of computed tomography scans by emergency physicians in blunt trauma

Checkpoint Head Skull fracture, Basal skull fracture, Brain contusion, Intracranial hemorrhage, Subarachnoid hemorrhage, Subdural hemorrhage, Epidural hemorrhage, Vascular injury
  Face Bone injury (Ophthalmology wall, Maxilla, Mandible, Zygomatic, Nose), Eyeball injury, Optic nerve injury, Vascular injury (if enhanced)
  Neck Bone injury (Cervical spine, Spinous process, Transverse process), Pharyngeal injury, Bronchial injury, Vascular injury (if enhanced)
  Chest Bone injury (Rib, Clavicle, Scapula, Sternum), Thoracic spine injury, Pneumothorax, Hemothorax Pulmonary injury, Bronchial injury, Cardiac injury, Cardiac tamponade, Esophageal injury Diaphragmatic injury, Vascular injury (if enhanced)
  Abdomen Bone injury (Lumber spine), Parenchymal organ injury (Liver, Gallbladder, Pancreas, Spleen, Kidney, Adrenal gland), Digestive tract injury, Free air, Mesenteric injury, Ureteral injury, Vascular injury (if enhanced)
  Pelvis Bone injury (Lumber spine, Ilium, Sacrum, Pubis, Ischium, Acetabular cartilage, Femur), Bladder injury, Urinary tract injury, Genital organ injury, Vascular injury (if enhanced)
Definition of misinterpretation
No misinterpretation All checkpoints were accurately cleared.
Minor misinterpretation Anatomical abnormalities were identified, but details were incomplete or incorrect. (e.g., rib fracture was identified but the injured number was misinterpreted; brain injury was pointed out, but the correct diagnosis such as subdural hemorrhage was not recorded.)
Major misinterpretation Anatomical abnormality described on CT was apparently missed even if EP received support by radiologist.
Gravity level The gravity level was determined upon review of the patient’s clinical course.
  Level 1 Clinical course was not affected by the EP’s interpretation.
  Level 2 Clinical course was affected by the EP’s misinterpretation.
   1) More invasive treatment was required because of the delayed detection of organ injuries.
   2) Temporary functional disorders or persistent cosmetic problems
   3) The course of treatment was unavoidably changed.
   4) Hospital stay was prolonged.
  Level 3 Clinical prognosis was seriously affected by the EP’s misinterpretation.
   1) Permanent, severe functional disorders or cosmetic problems (e.g., persistent disorder of consciousness, limb palsy, large scars)
   2) Death
  1. Checkpoints for each region were established in accordance with the Abbreviated Injury Scale (AIS).