Just wondering how y'all handle blunt trauma at your shops. I find that as I've become more senior in residency and am preparing for first year of attendinghood next year, I've become increasingly conservative, especially when it comes to trauma. Unless someone has a very non-concerning mechanism (fall from standing with no head trauma, fall off slow moving bicycle, fall down a few steps), is a good historian, is not intoxicated, is not elderly (i.e. osteopenic), not anti-coagulated...they are usually getting a pan-scan from me. I've just found too many things over my few years that I wasn't expecting to find (multiple rib fractures not detected on CXR (sometimes with small pneumothoraces), small splenic lacerations, small pulmonary contusions). Lots of these things likely won't end up being clinically relevant, however I think it's good for me / the patient to know that they are present and for them to get follow up for them / possible 1 night observation admission. There are times when I am on the fence and feel bad doing this. Another possible pathway is 3-5 hours of observation in the ED, serial FAST and serial physical exams. However, when I am managing 15 beds this just isn't possible.