Evaluation of a 16-MDCT scanner in an emergency department: initial clinical experience and workflow analysis.
OBJECTIVE
MDCT is especially suited for emergency purposes because it allows rapid high-resolution scans of large areas, fast high-quality reformatting in every orientation, and 3D illustration of the data set. In a prospective study, we evaluated the reliability and workflow of a dedicated emergency department 16-MDCT scanner in the management of patients presenting to the emergency department.


METHODS
The use of a 16-MDCT scanner for 503 patients in the emergency department of a university clinic was evaluated. For reasons of workflow analysis, seven precise time intervals were recorded during the emergency examinations. A new setting for repositioning multiple-trauma patients after imaging of the head and neck from the head-first position to the feet-first position was introduced.


RESULTS
Six (1.2%) of the 503 patients were excluded because of technical malfunction or patient noncompliance. Image quality in the remaining 497 cases, including CT angiography and CT of multiple-trauma patients, was outstanding. Positioning of the patients took from 3 to 13 min depending on the body region examined, representing 33-67% of the mean room time, which ranged from 8 to 21 min. In multiple-trauma patients, the initial positioning took a mean of 6 min and repositioning took 8 min, representing 19% and 26% of total room time, respectively.


CONCLUSIONS
The use of a dedicated 16-MDCT scanner in the emergency department resulted in short examination times even for examinations of multiple body regions under emergency conditions. The introduced setting-repositioning of multiple-trauma patients-allowed high image quality to be maintained. The trade-off in multiple-trauma patients was prolonged room time because of patient repositioning.
Department of Diagnostic Radiology, Inselspital, University of Bern, Freiburgstrasse 4, Bern, Switzerland.
Jan
J
Gralla
Franziska
F
Spycher
Christine
C
Pignolet
Christoph
C
Ozdoba
Peter
P
Vock
Hanno
H
Hoppe
D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging; D011446:Prospective Studies; D013997:Time Factors; D013996:Time and Motion Studies; D015898:Tomography Scanners, X-Ray Computed; D014057:Tomography, X-Ray Computed; D016526:Workload