title: Development of an accelerated MSCT protocol (Triage MSCT) for mass casualty incidents: comparison to MSCT for single-trauma patients.
abstract: During multiple casualty incidents (MCI) emergency radiology departments have to deal with a large number of patients with suspected severe trauma within a short period of time. The aim of this study was to develop a suitable accelerated multislice computed tomography (MSCT) protocol to increase patient throughput for this kind of emergency situation. We presumed a scenario of 15 patients being admitted to the trauma service with suspicion of severe injuries after a MCI over a period of 2 h. An accelerated Triage MSCT protocol was developed and evaluated for MSCT scanner productivity (patients per hour) and time (minutes) needed for a total MSCT body workup using an anthropomorphic phantom. In addition, time (minutes) for transfer and preparation was measured. These timeframes were compared to a control group consisting of 144 single patients with multiple trauma undergoing standard MSCT according to our trauma room protocol. All MSCT studies were conducted using a 4-detector row scanner. (1) For the study group (Triage MSCT), average time for patient transfer and preparation was 2.9 min (2.5-4.3 min), mean CT examination time was 2.1 min (1.7-2.4 min); image reconstruction took 4.0 min (3.3-4.3 min). Total time in scanner room was 8.9 min (7.7-11.3 min), resulting in a maximal productivity of 6.7 patients per hour. Image transfer to the digital picture archive and communication system archive was completed after an average 9.5 min (8.9-10.8 min). (2) For the control group (single casualty MSCT), the mean time for patient transfer and preparation was 20.4 min (9.0-39.2 min), mean examination time was 6.0 min (3.1-11.3 min). Times for image reconstructions were not recorded in the patient series. Mean total time in scanner room was 25.3 min (11.0-72.4 min), resulting in a patient throughput of 2.4 patients per hour. MSCT has potential to serve as a powerful tool in triage of multiple casualty patients. The introduction of a Triage MSCT scanning protocol resulted in an increase of patient throughput per hour by a factor of almost 3.
authors.affiliation: Department of Clinical Radiology, Ludwig-Maximilians-University Hospital, Nussbaumstrasse 20, 80336 Munich, Germany. markus.koerner@med.uni-muenchen.de
authors.forename: M
authors.initials: M
authors.lastname: Körner
authors.forename: M
authors.initials: M
authors.lastname: Krötz
authors.forename: K-G
authors.initials: KG
authors.lastname: Kanz
authors.forename: K-J
authors.initials: KJ
authors.lastname: Pfeifer
authors.forename: M
authors.initials: M
authors.lastname: Reiser
authors.forename: U
authors.initials: U
authors.lastname: Linsenmaier
mesh_terms: D002985:Clinical Protocols; D006801:Humans; D009104:Multiple Trauma / Q000000981:diagnostic imaging*; D019047:Phantoms, Imaging; D011857:Radiographic Image Interpretation, Computer-Assisted; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014194:Traumatology / Q000379:methods*; D014218:Triage / Q000379:methods; D016526:Workload