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

S Waldeck1, A Franke2, C Güsgen3

  • 1Klinik für diagnostische und interventionelle Radiologie und Neuroradiologie des Bundeswehrzentralkrankenhauses Koblenz, Rübenacherstr. 170, 56072, Koblenz, Deutschland. dr.waldeck@icloud.com.

Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
|March 20, 2019
PubMed
Summary

The SMAR3T protocol significantly reduces computed tomography (CT) reporting time for polytrauma patients, enabling faster surgical interventions without compromising diagnostic accuracy for critical injuries.

Keywords:
Computed tomographyDiagnosisEmergency trauma roomPolytraumaRadiology

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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.