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Purpose: Pelvic fracture evaluation with abdominopelvic computed tomography (CT) and formal CT cystography for rule out of urine bladder injury have been commonly employed in pediatric trauma patients. The additional delayed imaging required to obtain optimal CT cystography is, however, associated with increased doses of ionizing radiation to pelvic organs and represent a significant risk in the pediatric population for future carcinogenic risk. We hypothesized that avoidance of routine CT cystography among pediatric pelvic fracture victims would not result in an appreciable rate of missed bladder injuries and would aid in mitigating the radiation exposure risk associated with these additional images. Methods: A retrospective cohort study involving blunt trauma pelvic fractures among pediatric trauma patients (age

Introduction Mass Casualty Incidents (MCI) by Motor Vehicle Crashes (MVCs) are most common type of MCIs. Casualties from MCIs usually require more hospitalization resources. The purpose of this study was to compare the injury characteristics, survivability, and medical resource utilization of casualties from Mass-Casualty Motor Vehicle Crashes (MC-MVCs) and casualties from other (non MCI) MVCs. Methods This retrospective cohort study examined a population of 50,321 Israeli casualties hospitalized due to MVCs between 1998 and 2017, of which 595 (1.2%) were admitted from a MC-MVC. Analysis included type of motor vehicle involved and collision circumstances, injury characteristics, hospital resource utilization, and demographics. Results The results suggest that most casualties from MC-MVCs were bus passengers who were injured when the vehicle rolled over. Injuries from MC-MVCs were more urgent as almost two times more MC-MVCs casualties were rushed directly from the emergency room into the operating rooms and intensive care units than casualties of regular MVCs. Mortality rate was higher in MC-MVCs compared to regular MVCs (2.69% compared to 1.46%, respectively; p = .013). Severe injuries (ISS≥16) were more frequent in MC-MVCs (23.40% versus 15.53%, p Conclusions This study demonstrates that hospitals receiving casualties from MC-MVCs should expect not only a multitude of casualties, rather also the need to treat more urgent and severe injuries, in more body regions per casualty, and expect higher admissions rates to intensive care units and operation rooms under MCI conditions.