As advanced CT enables whole-body imaging in a short time and has become a useful imaging modality for trauma care, the concept of performing whole-body CT during initial trauma evaluation and care has been accepted and physicians in many institutions have put it into practice.
 However, JATEC does not recommend performing CT during a primary survey ; moreover, CT scanning for a hemodynamically unstable patient has been deemed inappropriate.
 Technical progress of CT and the setting of CT or IVR-CT in an emergency room make it easier to take a whole-body scan for trauma patients. In recent years, it has been reported that performing whole-body CT during a primary survey, even for hemodynamically unstable patients, decreases the mortality rate.
 Primary survey using conventional physical examinations and imaging may not be optimal anymore, and we should consider whole-body CT scanning, which can bring the best treatment in the shortest time, even for hemodynamically unstable patients.
 However, it is not always feasible or safe for hemodynamically unstable patients to undergo CT, so it is necessary for us to have the courage not to perform it when it is inappropriate.

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 The diagnostic criteria of "cardiac contusion" are clear pathologically, but ambiguous clinically, with a lack of agreement. The true incidence of this injury is unknown. It is also difficult to predict complications, but we can now select patients who do not need careful monitoring, using serum cardiac troponin and ECG. We should unify the term to "blunt cardiac injury".

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