Fung Kon Jin P H Ping, Goslings J Carel, Ponsen Kees Jan, van Kuijk Cees, Hoogerwerf Nico, Luitse Jan S
Trauma Unit Department of Surgery, Academic Medical Center, VU University Medical Center, Amsterdam, The Netherlands.
J Trauma. 2008 May;64(5):1320-6. doi: 10.1097/TA.0b013e318059b9ae.
We developed a new shockroom resuscitation setting that includes a moveable, multislice computed tomography (CT) scanner capable of scanning patients during the initial trauma resuscitation phase without (multiple) patient transfers that previously were necessary. This enables us to perform a complete diagnostic trauma workup, without leaving the shockroom. In this study, we assess the effect of the new Trauma Workflow Concept on the initial diagnostic workup times in the trauma room.
Data of 100 consecutive trauma patients were collected prospectively (2005 cohort) and compared with 100 consecutive trauma patients seen in our previous trauma resuscitation setting (2003 cohort). For all patients, time management was evaluated using video registration and complemented with electronic imaging times. Patients with and without CT scanning were compared with the effect of CT scanning on complete workup time, defined as time from admission to the trauma room to time of completion of diagnostic workup.
Patient demographics, including appliance of CT imaging were similar. Complete diagnostic workup for patients who underwent CT imaging took an average of 79 minutes (standard deviation +/- 29 minutes) in the 2005 cohort and 105 minutes (standard deviation +/- 48 minutes) in the 2003 cohort. Complete diagnostic workup without CT imaging took 56 minutes and 53 minutes for the 2005 and 2003 cohorts, respectively. There was no difference found for nonscanned patients, whereas there was a significant difference between 2005 and 2003 for scanned patients (p < 0.01).
Our new trauma workflow concept with a sliding CT scanner was significantly faster for completing the initial diagnostic workup, especially when CT imaging was required.
我们开发了一种新的休克室复苏设置，其中包括一台可移动的多层计算机断层扫描（CT）扫描仪，该扫描仪能够在初始创伤复苏阶段对患者进行扫描，而无需像以前那样进行（多次）患者转运。这使我们能够在不离开休克室的情况下完成完整的创伤诊断检查。在本研究中，我们评估了新的创伤工作流程概念对创伤室初始诊断检查时间的影响。
前瞻性收集了100例连续创伤患者的数据（2005年队列），并与在我们之前的创伤复苏设置中看到的100例连续创伤患者（2003年队列）进行比较。对于所有患者，使用视频记录评估时间管理，并辅以电子成像时间。比较了进行CT扫描和未进行CT扫描的患者，以及CT扫描对完整检查时间的影响，完整检查时间定义为从进入创伤室到诊断检查完成的时间。
患者人口统计学特征，包括CT成像的应用情况相似。在2005年队列中，接受CT成像的患者完成完整诊断检查的平均时间为79分钟（标准差±29分钟），在2003年队列中为105分钟（标准差±48分钟）。2005年和2003年队列中未进行CT成像的患者完成完整诊断检查的时间分别为56分钟和53分钟。未扫描患者之间没有差异，而2005年和2003年扫描患者之间存在显著差异（p < 0.01）。
我们采用滑动CT扫描仪的新创伤工作流程概念在完成初始诊断检查方面明显更快，尤其是在需要CT成像时。
