Körner M, Krötz M, Kanz K-G, Pfeifer K-J, Reiser M, Linsenmaier U
Department of Clinical Radiology, Ludwig-Maximilians-University Hospital, Nussbaumstrasse 20, 80336 Munich, Germany.
Emerg Radiol. 2006 Jul;12(5):203-9. doi: 10.1007/s10140-006-0485-9. Epub 2006 May 30.
During multiple casualty incidents (MCI) emergency radiology departments have to deal with a large number of patients with suspected severe trauma within a short period of time. The aim of this study was to develop a suitable accelerated multislice computed tomography (MSCT) protocol to increase patient throughput for this kind of emergency situation. We presumed a scenario of 15 patients being admitted to the trauma service with suspicion of severe injuries after a MCI over a period of 2 h. An accelerated Triage MSCT protocol was developed and evaluated for MSCT scanner productivity (patients per hour) and time (minutes) needed for a total MSCT body workup using an anthropomorphic phantom. In addition, time (minutes) for transfer and preparation was measured. These timeframes were compared to a control group consisting of 144 single patients with multiple trauma undergoing standard MSCT according to our trauma room protocol. All MSCT studies were conducted using a 4-detector row scanner. (1) For the study group (Triage MSCT), average time for patient transfer and preparation was 2.9 min (2.5-4.3 min), mean CT examination time was 2.1 min (1.7-2.4 min); image reconstruction took 4.0 min (3.3-4.3 min). Total time in scanner room was 8.9 min (7.7-11.3 min), resulting in a maximal productivity of 6.7 patients per hour. Image transfer to the digital picture archive and communication system archive was completed after an average 9.5 min (8.9-10.8 min). (2) For the control group (single casualty MSCT), the mean time for patient transfer and preparation was 20.4 min (9.0-39.2 min), mean examination time was 6.0 min (3.1-11.3 min). Times for image reconstructions were not recorded in the patient series. Mean total time in scanner room was 25.3 min (11.0-72.4 min), resulting in a patient throughput of 2.4 patients per hour. MSCT has potential to serve as a powerful tool in triage of multiple casualty patients. The introduction of a Triage MSCT scanning protocol resulted in an increase of patient throughput per hour by a factor of almost 3.
在多伤员事故（MCI）期间，急诊放射科必须在短时间内处理大量疑似严重创伤的患者。本研究的目的是制定一种合适的加速多层计算机断层扫描（MSCT）方案，以提高此类紧急情况下的患者通量。我们设想了这样一种场景：在2小时内，有15名因MCI而疑似受重伤的患者被收治到创伤科。我们制定了一种加速分诊MSCT方案，并使用人体模型评估了MSCT扫描仪的生产率（每小时患者数）以及完成全身MSCT检查所需的时间（分钟）。此外，还测量了转运和准备所需的时间（分钟）。将这些时间框架与一个对照组进行比较，该对照组由144名单发多处创伤的患者组成，他们根据我们的创伤室方案接受标准MSCT检查。所有MSCT检查均使用4排探测器扫描仪进行。（1）对于研究组（分诊MSCT），患者转运和准备的平均时间为2.9分钟（2.5 - 4.3分钟），平均CT检查时间为2.1分钟（1.7 - 2.4分钟）；图像重建耗时4.0分钟（3.3 - 4.3分钟）。在扫描室的总时间为8.9分钟（7.7 - 11.3分钟），每小时的最大生产率为6.7名患者。图像传输到数字图像存档和通信系统存档平均在9.5分钟（8.9 - 10.8分钟）后完成。（2）对于对照组（单发伤员MSCT），患者转运和准备的平均时间为20.4分钟（9.0 - 39.2分钟），平均检查时间为6.0分钟（3.1 - 11.3分钟）。患者系列中未记录图像重建时间。在扫描室的平均总时间为25.3分钟（11.0 - 72.4分钟），每小时的患者通量为2.4名患者。MSCT有潜力成为多伤员患者分诊的有力工具。引入分诊MSCT扫描方案使每小时的患者通量提高了近3倍。
