Abstract
PurposeThe trauma centre of the Wuerzburg University Hospital has integrated a pioneering dual-room twin-CT scanner in a multiple trauma pathway. For concurrent treatment of two trauma patients, two carbon CT examination and intervention tables are positioned head to head with one sliding CT-Gantry in the middle. The focus of this study is the process of trauma care with the time to CT (tCT) and the time to operation (tOR) as quality indicator.MethodsAll patients with suspected multiple trauma, who required emergency surgery and who were initially diagnosed by the CT trauma protocol between 05/2018 and 12/2018 were included. Data relating to time spans (tCT and tOR), severity of injury and outcome was obtained.Results110 of the 589 screened trauma patients had surgery immediately after finishing primary assessment in the ER. The ISS was 17 (9–34) (median and interquartile range, IQR). tCT was 15 (11–19) minutes (median and IQR) and tOR was 96.5 (75–119) minutes (median and IQR). In the first 30 days, seven patients died (6.4%) including two within the first 24 h (2%). There were two ICU days (1–6) (median and IQR) and one (0–1) (median and IQR) ventilator day.ConclusionThe twin-CT technology is a fascinating tool to organize high-quality trauma care for two multiple trauma patients simultaneously.
Highlights
The major reason for fatal outcome in trauma patients is the delay in life-saving surgery [1]
We collected the time to CT, the time to emergency surgery, the injury severity score (ISS) and outcome variables (mortality, ventilator-dependent days and length of intensive care unit (ICU) stay)
We found to CT (tCT) a little longer when compared with the previous studies in our level 1 trauma centre (15 min vs. 10 min) [3]
Summary
The major reason for fatal outcome in trauma patients is the delay in life-saving surgery [1]. After 14 years of clinical and scientific experience with this concept, we redefined the concept in 2018. This became necessary to fulfil the needs of growing numbers of trauma patients and to use the benefits of the newest technical scanner capabilities. For the concurrent treatment of two trauma patients, two carbon CT examination and intervention tables are positioned head to head with one sliding gantry CT in the middle (Fig. 1). Important devices, such as ventilator, ventilator tubing and central venous lines remain unaffected in position during the whole-body CT scan. In order to protect the staff and the second patient from radiation, a mobile wall can separate both resuscitation rooms
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