[SMAR³T©-a new time-saving diagnostic emergency room management algorithm]

Area of Science:

• Radiology
• Trauma Surgery
• Medical Imaging

Background:

• Primary computed tomography (CT) is crucial for diagnosing polytrauma, but faces challenges with interobserver reliability and reporting delays.
• Delays in CT report availability can postpone urgent surgical interventions in polytrauma patients.
• The clinical utility of primary CT in hemodynamically unstable polytrauma patients is under ongoing discussion.

Purpose of the Study:

• To develop and evaluate a standardized imaging and reporting protocol for initial CT diagnostics in polytrauma.
• The protocol aims to improve efficiency and reliability in diagnosing injuries requiring immediate treatment.

Main Methods:

• A novel imaging and reporting protocol, SMAR³T, was developed, featuring reduced thin-slice axial scan sequences and structured reporting.
• The SMAR³T protocol was applied to 30 polytrauma patients.
• The protocol's time efficiency and diagnostic quality were compared to conventional emergency room CT protocols.

Main Results:

• The SMAR³T protocol drastically reduced reporting time from an average of 59.6 minutes to 8.5 minutes (p < 10^-23).
• Both SMAR³T and conventional protocols successfully identified all life-threatening conditions and injuries requiring immediate treatment.
• A significant reduction in imaging data volume was observed with the SMAR³T protocol.

Conclusions:

• The SMAR³T algorithm significantly decreases time to surgical intervention for polytrauma patients.
• Diagnostic accuracy for life-threatening conditions is maintained with the SMAR³T protocol.
• Reduced imaging data facilitates potential telemedical transmission to specialized centers.