Mobile computerized tomography scanning in the neurosurgery intensive care unit:: increase in patient safety and reduction of staff workload
Mobile computerized tomography scanning in the neurosurgery intensive care unit:: increase in patient safety and reduction of staff workload
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DOI：
10.3171/jns.2000.93.3.0432
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发表时间：
2000-09-01
影响因子：
4.1
通讯作者：
Hillman, J
中科院分区：
文献类型：
--
作者：
Gunnarsson, T;Theodorsson, A;Hillman, J
对象。神经外科不稳定患者的转运存在生理参数扰动导致病情进一步恶化和继发性脑损伤的风险。移动计算机断层扫描（CT）头部扫描在神经外科重症监护（NICU）是一种新的技术，最大限度地减少了需要运输不稳定的病人。自1997年6月以来，作者一直在使用该设备，并开发了自己的扫描此类患者的方法。介绍了扫描程序和辐射安全措施。对89例患者在放射科运输及常规头部CT扫描过程中发生的并发症进行了前瞻性研究。将这些并发症与50例NICU患者移动CT扫描时发生的并发症进行比较。记录了这些程序的持续时间，并估计了工作人员的工作量。研究了两组被定义为高风险和中等风险病例的患者。在高危组和中危组中，分别有25%和20%的患者在常规CT扫描期间出现医疗和/或技术并发症。在移动CT扫描过程中，高危组和中危组并发症发生率分别为4.3%和0%。移动CT扫描所花费的时间也显著减少，估计的人员成本也降低了。移动CT扫描在新生儿重症监护病房是安全的。它最大限度地降低了与院内运输相关的生理恶化和技术事故的风险，这可能会加重继发性脑损伤。减少了患者在NICU受控环境之外的时间，减少了工作人员的工作量。
Object. Transportation of unstable neurosurgical patients involves risks that may lead to further deterioration and secondary brain injury from perturbations in physiological parameters. Mobile computerized tomography (CT) head scanning in the neurosurgery intensive care (NICU) is a new technique that minimizes the need to transport unstable patients. The authors have been using this device since June 1997 and have developed their own method of scanning such patients.Methods. The scanning procedure and radiation safety measures are described. The complications that occurred in 89 patients during transportation and conventional head CT scanning at the Department of Radiology were studied prospectively. These complications were compared with the ones that occurred during mobile CT scanning in 50 patients in the NICU. The duration of the procedures was recorded, and an estimation of the staff workload was made. Two patient groups, defined as high- and medium-risk cases, were studied. Medical and/or technical complications occurred during conventional CT scanning in 25% and 20% of the patients in the high- and medium-risk groups, respectively. During mobile CT scanning complications occurred in 4.3% of the high-risk group and 0% of the medium-risk group. Mobile CT scanning also took significantly less time, and the estimated personnel cost was reduced.Conclusions. Mobile CT scanning in the NICU is safe. It minimizes the risk of physiological deterioration and technical mishaps linked to intrahospital transport, which may aggravate secondary brain injury. The time that patients have to remain outside the controlled environment of the NICU is minimized, and the staff's workload is decreased.