First installation of a dual-room IVR-CT system in the emergency room

Daiki Wada,Koichi Hayakawa,Shuhei Maruyama,Yasuyuki Kuwagata,Fukuki Saito,Masahiro Kawada,Yasushi Nakamori,Shuji Kanayama,Hiromu Iwamura

doi:10.1186/s13049-018-0484-3

Daiki Wada, Koichi Hayakawa + Show 7 more

Open Access

https://doi.org/10.1186/s13049-018-0484-3

Copy DOI

Abstract

Computed tomography (CT) embedded in the emergency room has gained importance in the early diagnostic phase of trauma care. In 2011, we implemented a new trauma workflow concept with a sliding CT scanner system with interventional radiology features (IVR-CT) that allows CT examination and emergency therapeutic intervention without relocating the patient, which we call the Hybrid emergency room (Hybrid ER). In the Hybrid ER, all life-saving procedures, CT examination, damage control surgery, and transcatheter arterial embolisation can be performed on the same table. Although the trauma workflow realized in the Hybrid ER may improve mortality in severe trauma, the Hybrid ER can potentially affect the efficacy of other in/outpatient diagnostic workflow because one room is occupied by one severely injured patient undergoing both emergency trauma care and CT scanning for long periods. In July 2017, we implemented a new trauma workflow concept with a dual-room sliding CT scanner system with interventional radiology features (dual-room IVR-CT) to increase patient throughput. When we perform emergency surgery or interventional radiology for a severely injured or ill patient in the Hybrid ER, the sliding CT scanner moves to the adjacent CT suite, and we can perform CT scanning of another in/outpatient. We believe that dual-room IVR-CT can contribute to the improvement of both the survival of severely injured or ill patients and patient throughput.

Highlights

Introduction of Interventional radiology (IVR)Computed tomography (CT) into trauma workflow We initially implemented a new trauma workflow concept with a sliding CT scanner system with interventional radiology features (IVR-CT) that allows CT examination and emergency therapeutic intervention without relocating the patient, which we call the Hybrid emergency room (ER) (Fig. 1)
A multicentre randomised study by Sierink et al showed that diagnosing patients with an immediate total-body CT scan does not reduce in-hospital mortality compared with the standard radiological work-up, they suggested that improvement in the selection of patients who may benefit from immediate total-body CT should be the subject of future research [3]
We have shown that CT performed before emergency bleeding control might be associated with improved survival, especially in severe trauma patients with a Trauma

Summary

Background

Knowledge on whole-body computed tomography for trauma Whole-body computed tomography (WBCT) has gained importance in the early diagnostic phase of trauma care. Introduction of IVR-CT into trauma workflow We initially implemented a new trauma workflow concept with a sliding CT scanner system with interventional radiology features (IVR-CT) that allows CT examination and emergency therapeutic intervention without relocating the patient, which we call the Hybrid ER (Fig. 1). Introduction of dual-room IVR-CT into trauma workflow Being a one-room solution, the Hybrid ER can potentially affect the efficacy of other in/outpatient diagnostic workflow because one room is occupied by one severely injured patient undergoing both emergency trauma care and CT scanning. Frellesen et al reported that sliding-gantry CT embedded in a dual-room solution without IVR features allows for significant time savings in the diagnostic workup of polytrauma patients, and faster resumption of the regular in/outpatient CT schedule is possible [11]. In July 2017, we implemented a new trauma workflow concept with a dual-room IVR-CT to increase patient throughput

Main text

Findings

Conclusion