A Portable CT Scanner in the Pediatric Intensive Care Unit Decreases Transfer-Associated Adverse Events and Staff Disruption
A Portable CT Scanner in the Pediatric Intensive Care Unit Decreases Transfer-Associated Adverse Events and Staff Disruption
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DOI：
10.1007/s00068-009-9127-8
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发表时间：
2010-08-01
影响因子：
2.1
通讯作者：
Brierley, Joe
中科院分区：
文献类型：
--
作者：
Agrawal, Shruti;Hulme, Sara-Louise;Brierley, Joe
简介：计算机断层扫描（CT）是一种重要的诊断工具，在危重病儿童的管理，特别是那些与神经外科问题，如创伤性脑损伤。传统上，这种扫描需要转移到放射科（RD）在极端的生理不稳定的时候，如初期脑疝，并暴露儿童与实际的，或潜在的，脊柱损伤的转移风险。将儿童从儿科重症监护室（PIC）转移，通常是过夜，也会耗尽高级工作人员的单位。便携式CT（PCT）扫描提供了一个解决这个问题的方法，我们评估了患者的稳定性和工作人员的时间占用在紧急CT扫描之前和之后的PCT扫描仪（CereTom（R））在区域神经外科儿科重症监护室（PICU.Materials and Methods）：前瞻性观察研究呼吸机儿童在PICU需要紧急CT的头部，以限制继发性脑损伤。收集数据前三个月，并为同一时期后，引入PCT的问卷调查，旨在评估生理变量，PICU干预措施，和工作人员的时间，这是立即完成后scanning.Results：8名儿童有紧急CT头部扫描的RD在第一个3个月和10 PCT在第二个6个月。由于几乎每例患者的心肺不稳定或颅内压波动，转移到研发部的患者需要医疗干预，这明显增加了工作人员资源的压力。没有这些患者接受PCT有不良事件和工作人员资源少得多impacted upon.Discussion：PCT扫描是安全的不稳定的神经外科患者谁需要紧急诊断头部CT，减少与转移相关的风险和耗尽的工作人员提供给其他儿童在PICU。虽然本研究未专门讨论图像质量，但所有图像均具有扫描适应症的诊断性。
Introduction: Computerized tomography (CT) is an important diagnostic tool in the management of critically ill children, especially those with neurosurgical problems such as traumatic brain injury. Traditionally, such scans require transfer to the radiology department (RD) at times of extreme physiological instability, such as incipient cerebral herniation, and exposes children with actual, or potential, spinal injuries to the risks of transfer. Moving children from pediatric intensive care (PIC), often overnight, also depletes units of senior staff. Portable CT (PCT) scanning offers a solution to this problem, and we assessed patient stability and staff time occupied during urgent CT scans before and after the introduction of a PCT scanner (CereTom (R)) in a regional neurosurgical pediatric intensive care unit (PICU).Materials and Methods: Prospective observational study of ventilated children in the PICU requiring urgent CT of the head to limit secondary brain injury. Data was collected for three months prior to, and for the same period after, the introduction of PCT on a questionnaire designed to assess physiological variables, PICU interventions, and staff time, which was completed immediately post scanning.Results: Eight children had urgent CT head scan in the RD during the first 3 months and ten PCT in the second 6 months. The patients transferred to the RD required medical intervention because of cardio-respiratory instability or fluctuating intracranial pressure in nearly every patient and clearly increased the strain on staff resources. None of those patients undergoing PCT had untoward events and staff resources were far less impacted upon.Discussion: PCT scanning is safe for unstable neurosurgical patients who need urgent diagnostic head CT, reducing the risks associated with transfer and the depletion of staff provision to the other children in the PICU. While this study did not specifically address image quality, all images were diagnostic regarding the indication for scanning.