Northeast Ohio Medical University, Rootstown, OH, USA.
Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA.
Emerg Radiol. 2022 Oct;29(5):887-893. doi: 10.1007/s10140-022-02072-y. Epub 2022 Jun 28.
To evaluate the percentage of misplaced medical support lines and tubes in deceased trauma patients using post-mortem computed tomography (PMCT).
Over a 9-year period, trauma patients who died at or soon after arrival in the emergency department were candidates for inclusion. Whole body CT was performed without contrast with support medical devices left in place. Injury severity score (ISS) was calculated by the trauma registrar based on the injuries identified on PMCT. The location of support medical devices was documented in the finalized radiology reports.
A total of 87 decedents underwent PMCT, of which 69% (n = 60) were male. For ten decedents, the age was unknown. For the remaining 77 decedents, the average age was 48.4 years (range 18-96). The average ISS for the cohort was 43.4. Each decedent had an average of 3.3 support devices (2.9-3.6, 95% CI), of which an average of 1 (31.3%, 0.8-1.2, 95% CI) was malpositioned. A total of 60 (69.0%) had at least one malpositioned medical support device. The most commonly malpositioned devices were decompressive needle thoracostomies (n = 25/32, 78.1%). The least malpositioned devices were intraosseous catheters (n = 7/69, 10.1%). Nearly one quarter (n = 19/82, 23.2%) of mechanical airways were malpositioned, including 4.9% with esophageal intubation.
Malpositioned supportive medical devices are commonly identified on post-mortem computed tomography trauma decedents, seen in 69.0% of the cohort, including nearly one quarter with malpositioned mechanical airways. Post-mortem CT can serve as a useful adjunct in the quality improvement process by providing data for education of trauma and emergency physicians and first responders.
使用死后计算机断层扫描（PMCT）评估创伤死亡患者中错位的医疗支持线和管的百分比。
在 9 年期间，在急诊科死亡或很快死亡的创伤患者有资格入选。全身 CT 扫描不使用对比剂，同时保留支持医疗设备。创伤登记员根据 PMCT 上识别的损伤计算损伤严重程度评分（ISS）。支持医疗设备的位置记录在最终的放射学报告中。
共有 87 名死者进行了 PMCT，其中 69%（n=60）为男性。对于 10 名死者，年龄未知。对于其余 77 名死者，平均年龄为 48.4 岁（范围 18-96）。队列的平均 ISS 为 43.4。每位死者平均有 3.3 个支持设备（2.9-3.6，95%CI），其中 1 个（31.3%，0.8-1.2，95%CI）错位。共有 60 人（69.0%）至少有一个错位的医疗支持设备。最常见错位的设备是减压针胸腔穿刺术（n=25/32，78.1%）。最少错位的设备是骨髓内导管（n=7/69，10.1%）。近四分之一（n=19/82，23.2%）的机械气道错位，包括 4.9%的食管插管。
在创伤死亡患者的死后 CT 上经常发现错位的支持性医疗设备，在队列中的 69.0%中可见，包括近四分之一的机械气道错位。死后 CT 可以作为质量改进过程中的有用辅助手段，为创伤和急诊医生以及急救人员提供教育数据。
