[The "Würzburg T". A concept for optimization of early multiple trauma care in the emergency department].
BACKGROUND
Anaesthesia management, radiological diagnostic and the concept of damage control surgery should be combined in the resuscitation room. Defined clinical targets and their realisation are a CT-scan and complete damage control surgery in the shock room. Furthermore minimised patient transfer and positioning with continuous access to the head, upper parts of the body and anaesthesia machine should be realised during diagnostic procedures.


METHODS
Based on a carbon-slide fixed on a turntable and innovative alignment of diagnostic devices, a three phase treatment algorithm has been established.


RESULTS
Phase A includes primary survey, anaesthetic management and ultrasound examination. Following a turn of the table conventional x-ray diagnostic is assessed in phase B. Tracks for the slide enable immediate transfer to a spiral CT-scan without additional patient positioning (phase C). Following complete CT-scan rearrangement of the table to phase A facilitates immediate damage control surgery. To accelerate device operation and treatment the integrated anaesthesia workstation is ceiling-mounted and manoeuvres close to the patient.


CONCLUSIONS
This concept realizes complete diagnostic procedures and damage control surgery without time consuming patient transfer or rearrangement.
Kuhnigk
H
H
Klinik und Poliklinik für Anästhesiologie, Julius-Maximilians-Universität Würzburg. kuhnigk_h@klinik.uni-wuerzburg.de
Steinhübel
B
B
Keil
T
T
Roewer
N
N
D000465:Algorithms; D000758:Anesthesia; D004632:Emergency Medical Services / Q000458:organization & administration*; D005858:Germany; D006757:Hospital Units / Q000458:organization & administration*; D006801:Humans; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000628:therapy*; D013514:Surgical Procedures, Operative; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography