ACR Appropriateness Criteria® Major Blunt Trauma: Update 2025.

Trauma remains the leading cause of mortality in the United States for those <45 years of age, and it is the fourth leading cause of death overall. Polytrauma is defined as an injury to at least two body parts, including the head, neck, chest, abdomen, pelvis, or an extremity, with any one or a combination of these injuries being potentially fatal. This document covers imaging of major blunt trauma or polytrauma resulting in multiple organ injuries. Burn injuries, and injuries to pediatric patients are excluded. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.