Does the EM ban on letting sick patients go to CT scan make sense?
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Scott Weingart
An ED Intensivist from NY.
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Scott – great podcast. Now if you can find a way to convince the cardiologist that sick patients can undergo echocardiography at the bedside at 2am.
🙂
It seems very reasonable to send sick patients to CT, if properly prepared. Possibly creating a hospital protocol for these types of patients.
I love this topic. I loathe suspending appropriate patient care due to geography. Absolutely take the sick patient to CT, but be prepared.
This was an interesting argument but, the simplest solution is to bring the CT to the patient. Neurologica makes Portable CT scanners that are fully lead shielded, run on standard wall power or batteries, and can be rolled anywhere in the hospital or clinic. They have an 8 slice portable head and neck CT and they are getting ready to release a 32 slice portable full body CT with an 85 cm gantry and 60 cm field of view. In germany, some ambulances have Neurologica’s 8 slice portable CT to scan stroke patients on the spot. This idea of a fixed CT is out of date and it is slowly being replaced. If you don’t believe me check out http://www.neurologica.com.
I agree this is probably the wave of the future. I have seen the head ct version and it is an impressive machine. I would appreciate it if you have a financial interest in a product you espouse on this site, that you make that clear in your comment. It is fine to post, but please give your fellow readers some idea of your vantage.
Thanks,
Scott
…or use “we” instead of “they”…
Scott,
My apologies. I do work for NeuroLogica, but I only recently started working for them because they share passion in reducing patient transport. It’s a devastating feeling when you lose you someone whose life could have been spared if technology was just a few years more advanced. It’s my passion to find that technology and share it with world, so someone else won’t have to endure that pain. This is my vantage.
I truly appreciate your website. Thank you for sharing this information with world.
Kind Regards,
Benjamin Powell
NeuroLogica Marketing
Sounds good. Thanks, Benjamin.
I work with Joe C. one of your former residents – great job in his training I agree with your assessment re CT scan
To me it was like …..duh! why did I not think of this sooner
Thank You Scott
Phillip
thanks bud. Say hello to Joe!
Hey Scott I just re-listened to this in the light of the feedback our hospital received from the Quality Director following an audit of trauma patients attending our place (which would be known as a Level 2 Trauma Centre if we were in the US) which is recognised as a Trauma Unit in the UK, one below a Major Trauma Centre. Our ED is separated from the radiology department by one floor & 123 metres of hospital corridors. The audit recognised it regularly takes our doctors more than an hour to stabilise sick trauma patients prior to getting them to the CT scanner. It was felt that this delay could impact on the critical care decision making process and, as a consequence, delay the transfer of the patient to the level 1 trauma centre (the major trauma centre in the UK). This was likely to seriously impair the quality of care given. Our logistical concerns relate to a power cut & resulting elevator failure, which has previously resulted in a patient being stuck on the first floor, unable to get back down to the ED, or worse still, getting stuck in an elevator, with a sick patient. I completely agree… Read more »