title: Radiological mass casualty incident (MCI) workflow analysis: single-centre data of a mid-scale exercise.
abstract: OBJECTIVE
  The aim of the study was to analyse and interpret radiological mass casualty incident workflow data.
  
  
  METHODS
  In a mid-scale mass casualty incident exercise, the on-site triage assigned 12 cases to the investigated institution (11 included in the study). Two out of five institutional multislice-CT-scanners were used and the whole CT workflow and radiological service process chain were simulated as close to realistic as possible. The respective time intervals for reaching defined milestones were measured.
  
  
  RESULTS
  The average CT in-room time, i.e. from entering to leaving the CT room was 9.43 min [(standard deviation) SD: 2.27 min; 95% (confidence interval) CI: 7.90-10.95 min]. Time spent on CT table was 6.75 min (SD: 1.67; CI: 5.63-7.87), and the pure scan time was 4.22 min (SD: 0.64; CI: 3.79-4.65). The first images after entering the CT room were available at a dedicated CT workstation after 5.85 min (SD: 2.20; CI: 4.37-7.32) and institution wide via picture archiving system (PACS) after 7.85 min (SD: 1.27; CI: 7.00-8.71). However, the PACS archiving process, that is, transfer of standard reconstruction set of CT images into the PACS was finished after 20.85 min (SD: 2.97; CI: 18.85-22.84).
  
  
  CONCLUSIONS
  Up to six patients may be served per hour and per CT scanner by using a standard whole body CT polytrauma protocol. Dedicated CT triage protocols may even increase this number. The time portion until images were available at end points was relatively long. A solution has to be developed in order to avoid scenarios of patients being faster at end points than their images.
authors.affiliation: 1 Department of Clinical Radiology, LMU Hospital of the University of Munich, Munich, Germany.
authors.forename: Fabian G
authors.initials: FG
authors.lastname: Mueck
authors.affiliation: 1 Department of Clinical Radiology, LMU Hospital of the University of Munich, Munich, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Wirth
authors.affiliation: 1 Department of Clinical Radiology, LMU Hospital of the University of Munich, Munich, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Muggenthaler
authors.affiliation: 2 Department of Anesthesiology, LMU Hospital of the University of Munich, Munich, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Kreimeier
authors.affiliation: 1 Department of Clinical Radiology, LMU Hospital of the University of Munich, Munich, Germany.
authors.forename: Lucas
authors.initials: L
authors.lastname: Geyer
authors.affiliation: 3 Department of Trauma Surgery, Hospital of the Technical University Munich, Munich, Germany.
authors.forename: Karl-Georg
authors.initials: KG
authors.lastname: Kanz
authors.affiliation: 4 Department of diagnostic and interventional radiology, HELIOS Clinic Munich East, Munich, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Linsenmaier
authors.affiliation: 1 Department of Clinical Radiology, LMU Hospital of the University of Munich, Munich, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Wirth
mesh_terms: D006801:Humans; D054527:Mass Casualty Incidents; D009104:Multiple Trauma / Q000000981:diagnostic imaging; D016544:Patient Simulation; D013997:Time Factors; D015898:Tomography Scanners, X-Ray Computed / Q000706:statistics & numerical data*; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014218:Triage / Q000379:methods*; D057188:Workflow