Should the emergency IVP be used more selectively in blunt XXXX ?

@entity1 @entity8 @entity811 @entity812
A retrospective study was performed to determine if the emergency intravenous pyelogram (IVP) is being overused in the evaluation of blunt @entity8 . Medical records of 105 blunt @entity8 @entity1 undergoing IVPs for suspected blunt @entity8 were analyzed. Eighty-eight @entity1 (83.8%) had normal IVPs, and 17 @entity1 (16.2%) had abnormal IVPs. Three of the 105 @entity1 (2.9%) required urologic surgical intervention. The medical records of these @entity1 were examined in detail because it was believed that this @entity1 population needed to be identified by emergency IVP. All three @entity1 requiring urologic surgery had gross @entity811 . All three @entity1 had one or more associated injuries. Two of the three @entity1 had @entity812 . The third @entity1 was obtunded. From this study and information from the literature an algorithm has been constructed as a guideline for a prospective study. Following this guideline no @entity1 in the study requiring urologic surgical intervention would have been missed. Of @entity1 requiring an emergency IVP, 7.3% would have required urologic surgery. This would have resulted in a savings of  10,432 at our institution.
