Assessment of a new trauma workflow concept implementing a sliding CT scanner in the trauma room: the effect on workup times.
BACKGROUND
We developed a new shockroom resuscitation setting that includes a moveable, multislice computed tomography (CT) scanner capable of scanning patients during the initial trauma resuscitation phase without (multiple) patient transfers that previously were necessary. This enables us to perform a complete diagnostic trauma workup, without leaving the shockroom. In this study, we assess the effect of the new Trauma Workflow Concept on the initial diagnostic workup times in the trauma room.


METHODS
Data of 100 consecutive trauma patients were collected prospectively (2005 cohort) and compared with 100 consecutive trauma patients seen in our previous trauma resuscitation setting (2003 cohort). For all patients, time management was evaluated using video registration and complemented with electronic imaging times. Patients with and without CT scanning were compared with the effect of CT scanning on complete workup time, defined as time from admission to the trauma room to time of completion of diagnostic workup.


RESULTS
Patient demographics, including appliance of CT imaging were similar. Complete diagnostic workup for patients who underwent CT imaging took an average of 79 minutes (standard deviation +/- 29 minutes) in the 2005 cohort and 105 minutes (standard deviation +/- 48 minutes) in the 2003 cohort. Complete diagnostic workup without CT imaging took 56 minutes and 53 minutes for the 2005 and 2003 cohorts, respectively. There was no difference found for nonscanned patients, whereas there was a significant difference between 2005 and 2003 for scanned patients (p < 0.01).


CONCLUSIONS
Our new trauma workflow concept with a sliding CT scanner was significantly faster for completing the initial diagnostic workup, especially when CT imaging was required.
Fung Kon Jin
P H Ping
PH
Trauma Unit Department of Surgery, Academic Medical Center, VU University Medical Center, Amsterdam, The Netherlands.
Goslings
J Carel
JC
Ponsen
Kees Jan
KJ
van Kuijk
Cees
C
Hoogerwerf
Nico
N
Luitse
Jan S
JS
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010360:Patient Transfer; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014193:Trauma Centers / Q000458:organization & administration* / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000145:classification / Q000175:diagnosis* / Q000401:mortality