F Mück1, K Wirth2, M Muggenthaler2, K G Kanz3, U Kreimeier4, D Maxien2, U Linsenmeier5, W Mutschler6, S Wirth2. 1. Institut für Klinische Radiologie, Klinikum der Ludwig-Maximilians-Universität München, Nußbaumstr. 20, 80336, München, Deutschland. fabian.mueck@med.uni-muenchen.de. 2. Institut für Klinische Radiologie, Klinikum der Ludwig-Maximilians-Universität München, Nußbaumstr. 20, 80336, München, Deutschland. 3. Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675, München, Deutschland. 4. Klinik für Anästhesiologie, Klinikum der Ludwig-Maximilians-Universität München, Nußbaumstr. 20, 80336, München, Deutschland. 5. Institut für Interventionelle und Diagnostische Radiologie, HELIOS Klinikum München West, Steinerweg 5, 81241, München, Deutschland. 6. Klinik für Allgemeine, Unfall-, Hand- und Plastische Chirurgie, Ludwig-Maximilians-Universität München, Nußbaumstr. 20, 80336, München, Deutschland.
Abstract
BACKGROUND: Mass casualty incidents (MCI) have particularly high demands on patient care processes but occur rather rarely in daily hospital routine. Therefore, it is common to use simulations to train staff and to optimize institutional processes. OBJECTIVES: Aim of study was to compare the pre-therapeutic in-house workflow of two differently structured level 1 trauma sites in the case of a simulated mass casualty incident (MCI). MATERIALS AND METHODS: A MCI of 70 patients was simulated by actors in a manner that was as realistic as possible. The on-site triage assigned 7 cases to trauma site A with relatively long in-house distances and 4 patients to an independent trauma site B in which these distances were relatively short. During in-house treatment, time intervals for reaching milestones were measured and compared using the Mann-Whitney U test. RESULTS: As no simultaneous patient arrival occurred, the Patient Distribution Matrix proved to be effective. Site A needed more time (minutes) from admission to endpoints (A: 31.85 ± 7.99; B: 21.62 ± 4.76; p = 0.059). In detail, the time intervals were particularly longer for both patient stay in trauma room (A: 8.46 ± 3.02; B: 2.73 ± 0.78, p < 0.01) and transfer time to the CT room (A: 1.81 ± 0.62; B: 0.06 ± 0.03, p < 0.01). A shorter stay in the CT room did not compensate these effects (A: 8.86 ± 1.84; B: 10.40 ± 2.89, p = 0.571). For both sites, image calculation and distribution were relatively time consuming (17.36 ± 3.05). CONCLUSIONS: Although short in-house distances accelerated pretherapeutic treatment processes significantly, both sites remained clearly within the "golden hour". The strongest potential bottleneck was the time interval until images were available at the endpoints.
BACKGROUND: Mass casualty incidents (MCI) have particularly high demands on patient care processes but occur rather rarely in daily hospital routine. Therefore, it is common to use simulations to train staff and to optimize institutional processes. OBJECTIVES: Aim of study was to compare the pre-therapeutic in-house workflow of two differently structured level 1 trauma sites in the case of a simulated mass casualty incident (MCI). MATERIALS AND METHODS: A MCI of 70 patients was simulated by actors in a manner that was as realistic as possible. The on-site triage assigned 7 cases to trauma site A with relatively long in-house distances and 4 patients to an independent trauma site B in which these distances were relatively short. During in-house treatment, time intervals for reaching milestones were measured and compared using the Mann-Whitney U test. RESULTS: As no simultaneous patient arrival occurred, the Patient Distribution Matrix proved to be effective. Site A needed more time (minutes) from admission to endpoints (A: 31.85 ± 7.99; B: 21.62 ± 4.76; p = 0.059). In detail, the time intervals were particularly longer for both patient stay in trauma room (A: 8.46 ± 3.02; B: 2.73 ± 0.78, p < 0.01) and transfer time to the CT room (A: 1.81 ± 0.62; B: 0.06 ± 0.03, p < 0.01). A shorter stay in the CT room did not compensate these effects (A: 8.86 ± 1.84; B: 10.40 ± 2.89, p = 0.571). For both sites, image calculation and distribution were relatively time consuming (17.36 ± 3.05). CONCLUSIONS: Although short in-house distances accelerated pretherapeutic treatment processes significantly, both sites remained clearly within the "golden hour". The strongest potential bottleneck was the time interval until images were available at the endpoints.
Authors: Markus Körner; Michael M Krötz; Stefan Wirth; Stefan Huber-Wagner; Karl-Georg Kanz; Holger F Boehm; Maximilian Reiser; Ulrich Linsenmaier Journal: Eur Radiol Date: 2009-03-11 Impact factor: 5.315
Authors: Pamela T Johnson; William W Scott; Bob W Gayler; Jonathan S Lewin; Elliot K Fishman Journal: AJR Am J Roentgenol Date: 2014-06 Impact factor: 3.959
Authors: H J Bail; C Kleber; N P Haas; P Fischer; L Mahlke; G Matthes; S Ruchholtz; J W Weidringer Journal: Unfallchirurg Date: 2009-10 Impact factor: 1.000
Authors: Stefan Huber-Wagner; Rolf Lefering; Lars-Mikael Qvick; Markus Körner; Michael V Kay; Klaus-Jürgen Pfeifer; Maximilian Reiser; Wolf Mutschler; Karl-Georg Kanz Journal: Lancet Date: 2009-03-25 Impact factor: 79.321
Authors: Lucas L Geyer; Markus Koerner; Stefan Wirth; Fabian G Mueck; Maximilian F Reiser; Ulrich Linsenmaier Journal: Semin Musculoskelet Radiol Date: 2013-10-07 Impact factor: 1.777
Authors: Charles L Sprung; Janice L Zimmerman; Michael D Christian; Gavin M Joynt; John L Hick; Bruce Taylor; Guy A Richards; Christian Sandrock; Robert Cohen; Bruria Adini Journal: Intensive Care Med Date: 2010-02-05 Impact factor: 17.440
Authors: M G Wagner; M R Fischer; M Scaglione; U Linsenmaier; G Schueller; F H Berger; E Dick; R Basilico; M Stajgis; C Calli; S Vaidya; Stefan Wirth Journal: GMS J Med Educ Date: 2017-11-15
Authors: Stefan Wirth; Julian Hebebrand; Raffaella Basilico; Ferco H Berger; Ana Blanco; Cem Calli; Maureen Dumba; Ulrich Linsenmaier; Fabian Mück; Konraad H Nieboer; Mariano Scaglione; Marc-André Weber; Elizabeth Dick Journal: Insights Imaging Date: 2020-12-10