CT scans in the

emergency department
They may not be needed as often as you think
If you or someone you care for is in the emergency department, you
want the medical staff to do everything they can to find out what’s
wrong and provide the right treatment. The doctors in the emergency
room (ER) want the same thing.
There are times when a CT scan (Computerized Tomography Scan,
sometimes called a CAT scan) might be needed to help with the
diagnosis. A CT scan uses X-rays to take pictures of your insides.
If your doctor orders a CT scan, ask why you need it. And ask if your
health problem could be managed without it. These facts about CT
scans can help you talk with your doctor about them.
 CT scans for head injuries
Head injuries are a common reason for going to the ER.
Most head injuries don’t involve something that needs
to be found with a CT scan, such as skull fractures or
bleeding in the brain.
Each patient is different. So be sure to give your
health history and get an exam. The history and
exam can help your doctor decide how bad your
injury is. If your head injury is not serious, a CT scan
will not give your doctor useful information. So there
is no reason to do the test.
Even if you briefly pass out, you probably don’t need
a CT scan unless you have a major head injury. In that
case, you will have certain symptoms. For instance, you may
keep throwing up or have an altered mental state.

Sometimes people think they need a CT scan if they pass out, even if they did not hit their heads.
People sometimes think that passing out is a sign of a stroke or bleeding in the brain, but it almost
never is. If you don’t have any other symptoms and your exam is normal, a CT scan is not likely to
give your doctor any helpful information.

You may need a CT scan of your head if you have dangerous symptoms, such as:

! Changes in mental state or alertness

! Throwing up again and again

! Injury that your doctor can see or feel

! Very bad headache that
starts suddenly

! Signs of a stroke (You may suddenly

feel dizzy. Your face, arm, or leg may
be weak or numb, especially on one
side of your body. Or you may have
trouble seeing.)

CT scans may also be advised for patients with minor head injuries who take blood
thinners. These include warfarin (Coumadin), rivaroxaban (Xarelto), and clopidogrel
(Plavix), or one of the generic versions of those drugs. That’s because these patients are
more likely to bleed from minor injuries. Bleeding in the brain is serious.
CT scans for kidney stones CT scans for blood clots in the lungs
A kidney stone is a solid piece of material A blood clot in the lungs is a very bad health
that forms in your kidney. It may stay in your problem. It’s also called a pulmonary embolism,
kidney or travel down your urinary tract. or PE.
Signs of kidney stones Signs of blood clots
If you have kidney stones, If you have a blood clot in
you may: your lungs, you may have:
•F eel sick to your stomach •C  hest pain that gets worse
•H ave very bad, sudden when you take deep breaths
pain in your back or • Coughing up blood
upper belly •F  ast heartbeat
•T hrow up •H  eart strain (Your doctor
Tests you may need can look for this with a
simple, painless test called
Here are some tests you may need if you have
an EKG.)
signs of kidney stones:
• Swelling in your legs
• Blood test. This test
checks how well your •T  rouble breathing
kidneys are working. Risk factors for blood clots
• Urine test. This test
checks for signs of kidney You are more likely to have a blood clot in your
stones and infection. lungs if you:
•C  T scan of your belly and pelvis. This test •A  re age 50 or older
checks for other health problems, such as •H  ave been injured or had surgery in the last
gall bladder disease. This test is only done four weeks
if you have never had kidney stones before. • Have had blood clots or an abnormal
If you have had kidney stones before, you do heartbeat before
not need this test. •U  se birth control with hormones
If you have kidney stones Tests you may need
If you have kidney stones, they will likely pass
Here are some tests you may need if you have
on their own within two weeks. If they don’t,
signs and risk factors for blood clots:
a doctor must remove the stones. The doctor
might need to do an ultrasound first to check • D-dimer test. You may need this test if you have
their size and where they are. This test is safe. just a few signs and risk factors for blood clots.
It uses sound waves instead of X-rays to take This blood test looks for signs that your body is
pictures of your insides. You will not need a trying to dissolve a blood clot. A positive result
CT scan to check the size and location of the does not always mean you have a blood clot in
kidney stones. your lungs.
The next time you have signs of kidney stones, •C  T scan. You may need this test if you have all or
you likely won’t need another CT scan. Your most of the signs and risk factors for blood clots.
health history, urine tests, and blood tests You may also need a CT scan if your D-timer test
should tell your doctor if you have kidney is positive. A CT scan should not be the first test
stones again. You’ll need a CT scan only if: you get.
•Y  ou are age 50 or older, or
• Your signs are not clearly caused by
kidney stones
Advice from Consumer Reports

Don’t get CT scans CT scans are costly

unless you need them CT scans can also be very expensive,
Each CT scan gives you a large dose of especially in the ER.
radiation. In some cases, it’s equal to
the dose from about 200 chest X-rays. How much radiation
Radiation can damage your tissues. Your are you getting?
body can often repair that damage—but
not always. And when it doesn’t, the The chart below shows the dose of
damage could lead to cancer. radiation from common CT scans
compared to the dose from natural sources,
The risk from a single CT scan is very low.
such as radon. Doses are typical values for
But the more CT scans you get in your
an adult of average size. The actual dose
lifetime, the higher your risk of cancer. CT
can vary greatly. It depends on how big you
scans can be especially harmful to children.
are and what type of scan you get.

CT of head = CT of spine = CT of belly and pelvis = CT of heart =

8 months of 2 years of 3 years of 4 years of
natural radiation natural radiation natural radiation natural radiation

This report is for you to use when talking with your healthcare provider.
It is not a substitute for medical advice and treatment. Use of this report is at your own risk.
© 2016 Consumer Reports. Developed in cooperation with the American College of Emergency Physicians.