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Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2018

Open Access 01-12-2018 | Commentary

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

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

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2018

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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.
Literature
1.
go back to reference Huber-Wagner S, Lefering R, Qvick LM, Körner M, Kay MV, Pfeifer KJ, et al. Effect of whole-body CT during trauma resuscitation on survival: a retrospective, multicentre study. Lancet. 2009;373:1455–61.CrossRefPubMed Huber-Wagner S, Lefering R, Qvick LM, Körner M, Kay MV, Pfeifer KJ, et al. Effect of whole-body CT during trauma resuscitation on survival: a retrospective, multicentre study. Lancet. 2009;373:1455–61.CrossRefPubMed
2.
go back to reference Yeguiayan JM, Yap A, Freysz M, Garrigue D, Jacquot C, Martin C, et al. Impact of whole-body computed tomography on mortality and surgical management of severe blunt trauma. Crit Care. 2012;16:R101.CrossRefPubMedPubMedCentral Yeguiayan JM, Yap A, Freysz M, Garrigue D, Jacquot C, Martin C, et al. Impact of whole-body computed tomography on mortality and surgical management of severe blunt trauma. Crit Care. 2012;16:R101.CrossRefPubMedPubMedCentral
3.
go back to reference Sierink JC, Treskes K, Edwards MJ, Beuker BJ, Hartog D, Hohmann J, et al. Immediate total-body CT scanning versus conventional imaging and selective CT scanning in patients with severe trauma (REACT-2): a randomised controlled trial. Lancet. 2016;388:673–83.CrossRefPubMed Sierink JC, Treskes K, Edwards MJ, Beuker BJ, Hartog D, Hohmann J, et al. Immediate total-body CT scanning versus conventional imaging and selective CT scanning in patients with severe trauma (REACT-2): a randomised controlled trial. Lancet. 2016;388:673–83.CrossRefPubMed
4.
go back to reference Wada D, Nakamori Y, Yamakawa K, Yoshikawa Y, Kiguchi T, Tasaki O, et al. Impact on survival of whole-body computed tomography before emergency bleeding control in patients with severe blunt trauma. Crit Care. 2013;17:R178.CrossRefPubMedPubMedCentral Wada D, Nakamori Y, Yamakawa K, Yoshikawa Y, Kiguchi T, Tasaki O, et al. Impact on survival of whole-body computed tomography before emergency bleeding control in patients with severe blunt trauma. Crit Care. 2013;17:R178.CrossRefPubMedPubMedCentral
5.
go back to reference Huber-Wagner S, Biberthaler P, Häberle S, Wierer M, Dobritz M, Rummeny E, et al. Whole-body CT in haemodynamically unstable severely injured patients--a retrospective, multicentre study. PLoS One. 2013;8:e68880.CrossRefPubMedPubMedCentral Huber-Wagner S, Biberthaler P, Häberle S, Wierer M, Dobritz M, Rummeny E, et al. Whole-body CT in haemodynamically unstable severely injured patients--a retrospective, multicentre study. PLoS One. 2013;8:e68880.CrossRefPubMedPubMedCentral
6.
go back to reference Hilbert P, Zur Nieden K, Hofmann GO, Hoeller I, Koch R, Stuttmann R. New aspects in the emergency room management of critically injured patients: a multi-slice CT-oriented care algorithm. Injury. 2007;38:552–8.CrossRefPubMed Hilbert P, Zur Nieden K, Hofmann GO, Hoeller I, Koch R, Stuttmann R. New aspects in the emergency room management of critically injured patients: a multi-slice CT-oriented care algorithm. Injury. 2007;38:552–8.CrossRefPubMed
7.
go back to reference Fung Kon Jin PH, Gostlings JC, Ponsen KJ, van Kuijk C, Hoogerwerf N, Luitse JS. Assessment of a new trauma workflow concept implementing a sliding CT scanner in the trauma room: the effect on workup times. J Trauma. 2008;64:1320–6.CrossRefPubMed Fung Kon Jin PH, Gostlings JC, Ponsen KJ, van Kuijk C, Hoogerwerf N, Luitse JS. Assessment of a new trauma workflow concept implementing a sliding CT scanner in the trauma room: the effect on workup times. J Trauma. 2008;64:1320–6.CrossRefPubMed
8.
go back to reference Wurmb TE, Frühwald P, Hopfner W, Keil T, Kredel M, Brederlau J, et al. Whole-body multislice computed tomography as the first line diagnostic tool in patients with multiple injuries: the focus on time. J Trauma. 2009;66:658–65.CrossRefPubMed Wurmb TE, Frühwald P, Hopfner W, Keil T, Kredel M, Brederlau J, et al. Whole-body multislice computed tomography as the first line diagnostic tool in patients with multiple injuries: the focus on time. J Trauma. 2009;66:658–65.CrossRefPubMed
9.
go back to reference Wada D, Nakamori Y, Yamakawa K, Fujimi S. First clinical experience with IVR-CT system in the emergency room: positive impact on trauma workflow. Scand J Trauma Resusc Emerg Med. 2012;20:52.CrossRefPubMedPubMedCentral Wada D, Nakamori Y, Yamakawa K, Fujimi S. First clinical experience with IVR-CT system in the emergency room: positive impact on trauma workflow. Scand J Trauma Resusc Emerg Med. 2012;20:52.CrossRefPubMedPubMedCentral
10.
go back to reference Kinoshita T, Yamakawa K, Matsuda H, Yoshikawa Y, Wada D, Hamasaki T, et al. The survival benefit of a novel trauma workflow that includes immediate whole-body computed tomography, surgery, and interventional radiology, all in one trauma resuscitation room: a retrospective historical control study. Ann Surg. 2017; https://doi.org/10.1097/SLA.0000000000002527. [Epub ahead of print] Kinoshita T, Yamakawa K, Matsuda H, Yoshikawa Y, Wada D, Hamasaki T, et al. The survival benefit of a novel trauma workflow that includes immediate whole-body computed tomography, surgery, and interventional radiology, all in one trauma resuscitation room: a retrospective historical control study. Ann Surg. 2017; https://​doi.​org/​10.​1097/​SLA.​0000000000002527​. [Epub ahead of print]
11.
go back to reference Frellesen C, Boettcher M, Wichmann JL, Drieske M, Kerl JM, Lehnert T, et al. Evaluation of a dual-room sliding gantry CT concept for workflow optimisation in polytrauma and regular in- and outpatient management. Eur J Radiol. 2015;84(1):117–22.CrossRefPubMed Frellesen C, Boettcher M, Wichmann JL, Drieske M, Kerl JM, Lehnert T, et al. Evaluation of a dual-room sliding gantry CT concept for workflow optimisation in polytrauma and regular in- and outpatient management. Eur J Radiol. 2015;84(1):117–22.CrossRefPubMed
Metadata
Title
First installation of a dual-room IVR-CT system in the emergency room
Authors
Daiki Wada
Yasushi Nakamori
Shuji Kanayama
Shuhei Maruyama
Masahiro Kawada
Hiromu Iwamura
Koichi Hayakawa
Fukuki Saito
Yasuyuki Kuwagata
Publication date
01-12-2018
Publisher
BioMed Central
DOI
https://doi.org/10.1186/s13049-018-0484-3

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