延迟急诊室的根本原因分析 计算机断层扫描 扫描 计算机断层扫描
Arjun Dhanik1,2,3, Bryan A Stenson1,2,3, Robin B Levenson1,2
1Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts.
The western journal of emergency medicine
|April 10, 2024
概括
紧急部门的计算机断层扫描 (CT) 延迟通常是由患者因素和成像协议造成的. 诸如静脉输入和对比方案等可修改因素可以减少CT周转时间,改善患者流动.
科学领域:
- 紧急医疗 紧急医疗
- 放射学 放射学是一门学科.
- 医疗保健操作 医疗保健操作
背景情况:
- 紧急部门 (ED) 的拥堵是医疗保健的一个重大挑战.
- 越来越多地依赖于先进的成像技术,如计算机断层扫描 (CT),导致ED瓶.
- 图像扫描的周转时间是影响ED患者流动和护理的关键因素.
研究的目的:
- 确定导致CT扫描完成显著延迟的因素,在城市的第三级护理ED.
- 分析CT周转时间延长的患病率和原因.
主要方法:
- 在三个月内对4,344名患者进行的5,685次CT扫描进行了回顾性分析.
- 异常值的定义是从订单到完成超过369分钟的CT扫描.
- 系统地查看异常病例的图表,以确定导致因素及其频率.
主要成果:
- 确定了182个异常值 (占CT总量的4.2%),其中167个在排除后进行分析.
- 关键的延迟因素包括:患者不合规/不稳定 (22.8%),静脉注射 (IV) 线问题 (18.0%),对比性过敏 (14.4%),淋巴细胞过率 (GFR) 问题 (12.6%) 和成像协议问题 (12.0%).
- 很大一部分延误 (32.9%) 的原因尚不清楚.
结论:
- 无论是可修改的还是不可修改的因素都会导致EDCT扫描延迟.
- 与患者相关的因素 (行为,敏度,过敏) 是显著的,但不可改变的.
- 针对IV接入,低GFR对比度使用和成像协议的机构政策提供了改进的机会,可能减轻高达42.6%的延迟.
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