Department of Interventional Radiology, School of Medicine, University Hospital Klinikum Rechts der Isar, Technical University of Munich, München, Germany.
PLoS One. 2024 Nov 12;19(11):e0313008. doi: 10.1371/journal.pone.0313008. eCollection 2024.
Research of interventional treatment success in arterial bleeding cases is almost exclusively focused on technical and procedural factors. This study investigates the effect of an improved preprocedural activation algorithm for acute arterial bleedings treated by interventional radiology.
During the three-year study period (2018-2021), the authors implemented an always-reachable, simple-to-remember emergency phone number routed to the responsible interventional radiologist on call and compared this pathway to the previous activation process. Data were acquired for all emergency cases with active arterial bleeding detected in CT scans and the diagnosis to treatment intervals before and after implementation were retrospectively analysed. Time signatures in CT and angiography were used to determine the interval.
1322 calls or contacts occurred during the study period. In general, 625 emergency procedures were conducted; 120 bleeding interventions met the study requirements. In the study 44 patients were treated via the conventional pathway and 76 via the emergency phone activation. The activation algorithm utilizing the emergency phone led to a slight decrease in radiation doses and fluoroscopy time and a significant reduction (15min) in diagnosis to treatment intervals (p = 0.019). After implementing the emergency phone, the technical success rate increased significantly from 68% to 94% (p<0.001).
This study shows that effective communication structures, such as implementing a standardized activation pathway via an emergency phone, can significantly reduce diagnosis to treatment intervals and increase technical success rates. Effective communication is crucial for interventional radiology to deal with acute and life-threatening conditions requiring immediate treatment. This study presents a possible improvement and provides valuable insight for interventional radiology clinics seeking to optimize their communication and management strategies for emergency cases.
介入治疗动脉出血病例的研究几乎完全集中在技术和程序因素上。本研究调查了一种改进的急性动脉出血介入治疗前激活算法的效果。
在三年的研究期间（2018-2021 年），作者实施了一个始终可及、易于记忆的紧急电话号码，直接转接到负责的介入放射科医生，并将此途径与之前的激活流程进行了比较。对所有在 CT 扫描中检测到的活动性动脉出血的紧急病例采集数据，并回顾性分析实施前后的诊断至治疗间隔。使用 CT 和血管造影的时间标记来确定间隔。
在研究期间共发生了 1322 次呼叫或联系。一般来说，进行了 625 次紧急手术；120 次出血干预符合研究要求。在研究中，44 名患者通过常规途径治疗，76 名患者通过紧急电话激活治疗。使用紧急电话的激活算法导致辐射剂量和透视时间略有下降，诊断至治疗间隔显著缩短（15 分钟）（p = 0.019）。实施紧急电话后，技术成功率从 68%显著提高到 94%（p<0.001）。
本研究表明，有效的沟通结构，如通过紧急电话实施标准化激活途径，可以显著缩短诊断至治疗间隔并提高技术成功率。有效的沟通对于介入放射学处理需要立即治疗的急性和危及生命的情况至关重要。本研究提出了一种可能的改进方法，并为介入放射学诊所提供了有价值的见解，以优化其紧急情况下的沟通和管理策略。
