The large sample size will make sure that results are reliable and can be generalized to all international trauma populations and centers. Conclusion The REACT-2 trial is an international multicenter learn more randomized clinical trial http://ClinicalTrials.gov/NCT01523626 to compare immediate total-body CT scanning during the primary survey of severely injured trauma patients with conventional imaging strategies supplemented by selective CT scanning. Prospective The REACT-2 inclusion has started in April 2011. Results are expected in mid 2014. Abbreviations Inhibitors,research,lifescience,medical ATLS: Advanced Trauma Life Support; AIS: Abbreviated Injury Score; AMC: Academic Medical Center;

ED: Emergency Department; FAST: Focused Assessment with Sonography for Trauma; GCS: Glascow Coma Scale; ICU: Intensive Inhibitors,research,lifescience,medical Care Unit; mGy: Milligray; ISS: Injury Severity Score; mSv: Millisievert; REACT-2: Randomized study of Early Assessment by CT scanning in Trauma patients -2; CT: Computed Tomography. Competing interests J.C. Sierink, MD, is a Ph.D.-student at the Trauma Unit Department of Surgery, employed by the AMC Medical Research B.V., and supported by an unrestricted grant from ZonMw, the Netherlands Inhibitors,research,lifescience,medical organisation for health research and development (grant number: 1711020323).

All authors declare that they have no competing interests. Authors’ contributions JCS drafted the manuscript, TPS and JCG co-authored the writing of the manuscript. All authors participated actively in the design of the trial and critically appraised the manuscript. All authors read and approved the final manuscript. Pre-publication Inhibitors,research,lifescience,medical history The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1471-227X/12/4/prepub Acknowledgements

ZonMw, the Netherlands organisation for health research and development (grant number: 1711020323) funded the REACT-2 trial.
In the past two years, frequent mass casualty incidents (MCIs) stemming from political conflicts have occurred in Bangkok, Thailand. The first occurred October 7, 2008 and the second April, 2009 when Phramongkutklao’s emergency Inhibitors,research,lifescience,medical rescue teams were activated in a local emergency response system. However, no published study has reported these MCIs. This study investigated the MCI stemming from political conflict April 10, 2010. This political conflict deviated from peaceful protest to metropolitan riotousness and had different characteristics from the past such as weapons of mass destruction were used by unknown forces whatever leading to military MCI. Fortunately, in this event, integration of each army medical support unit merging with civilian medical services ensured provision of comprehensive care for all casualties. Prehospital treatment received cooperation from many government sectors including the Ministry of Defence that prepared field-operation military medical teams to transport injured soldiers to Phramongkutklao (PMK) Hospital, the main military level 1 trauma center in the Bangkok metropolis.