Markus Koerner MD, Presenter: Nothing to Disclose

Stefan Wirth MD, Abstract Co-Author: Nothing to Disclose

Stefan Huber-Wagner MD, Abstract Co-Author: Nothing to Disclose

Karl-Georg Kanz MD, Abstract Co-Author: Nothing to Disclose

Maximilian F. Reiser MD, Abstract Co-Author: Nothing to Disclose

Ulrich Linsenmaier MD, Abstract Co-Author: Nothing to Disclose

To evaluate the feasibility and reproducibility of a CT triage protocol in two large-scale exercises simulating a mass casualty incident and to identify possible training effects.

The training incident was a bomb explosion at the local soccer stadium for both simulations taking place in a 6 month interval, with approximately 100 casualties each. Seven individuals that were triaged on-site as “critical” were admitted to our emergency department and underwent whole-body CT on a 4-slice MDCT scanner. For simulation of the image reading, selected anonymous patient cases had to be viewed by the radiologists on duty blinded to the final diagnosis. The times needed for patient transfer and preparation, examination, image reconstruction, total room time, image transfer to PACS, and image reading were recorded, and average capacities were calculated. The critical timeframes influencing capacities from both exercises were compared to each other for significant differences and training effects using the t-test.

There were no significant time differences for patient transfer and preparation (2.3 vs. 2.5 min.), duration of CT examination (2.7 vs. 2.8 min.), image reconstruction (2.6 vs. 2.5 min.), time in scanner room (6.4 vs. 6.1 min.), PACS transfer (3.9 vs. 3.4 min.), and image reading (7.3 vs. 8.3 min.). The calculated capacities per hour were 9.4 and 9.8 for CT examinations completed, 15.4 and 17.7 for studies transferred to PACS, 8.2 and 7.2 for reports completed. The patient admission rates (5.5 and 7.4 per hour) were substantially lower than the examination capacity and at least equal to the reading capacity.

The analysis of two separate simulations showed reproducible results for CT triage workflow but no measurable training effects. Consequently, CT can be used as a secondary triage tool in mass casualty incidents using a dedicated and fast protocol.

CT can be used as a secondary triage tool in mass casualty incidents using a dedicated and fast protocol.

Koerner, M, Wirth, S, Huber-Wagner, S, Kanz, K, Reiser, M, Linsenmaier, U, Improved CT Workflow for Mass Casualty Incidents: Feasibility and Reproducibility of a Dedicated CT Triage Protocol with Results from Two Large-scale Exercises.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6012264.html