Improving CT scanner efficiency for trauma team activations in the emergency department

Background and objectives: A Trauma Team Activation (TTA) is initiated when a patient has sustained a life or limb-threatening injury thereby necessitating resources of a large care team. Previously, a CT scanner was cleared at the time of the prehospital TTA call. Wide variability in the time it took to stabilize patients often led to ex-tended CT scanner idle time. A new policy was developed whereby the team leader would prompt the ED clerk to provide a '5-min heads-up' (5-min HU) notification to the CT scanner personnel as a patient was stabi-lized. At this point, the CT scanner was cleared. The purpose of this quality improvement project is to evaluate if the new policy saves CT scanner idle time. Methods: Research interns prospectively followed incoming TTAs in the ED of a large, urban, Level I Trauma Center in November 2022. The interns collected the following time points: TTA notification page, 5-min HU no-tification, and arrival to CT. Data was analyzed using a non-parametric comparison test (Mann-Whitney U).Results: A convenience sample of 46 TTAs was included. Trauma was blunt (85%; n = 39)) and penetrating (15%; n = 7). The median initial TTA announcement to CT arrival time was 24.0 min (IQR: 9.0 min). Previously, the scanner would have been held for this entire period. The median time from 5-min HU notification to CT arrival was 5.0 min (IQR: 4.0 min). The new policy saved a median of 19 min of CT scanner idle time per patient com-pared to the old policy (p < 0.0001). The total CT scanner time saved was 818 min (13.6 h). Conclusion: These data support the implementation of a 5-min HU policy in the ED for patients arriving as TTAs. This maximizes the availability of CT scanners for other patients in the ED while TTA patients are being stabilized.(c) 2023 Elsevier Inc. All rights reserved.

Automated summary

This study aims to evaluate whether a new policy can save idle time of CT scanner. The results showed that the new policy saved an average of 19 minutes of CT scanner idle time per patient, with a total saving of 818 minutes (13.6 hours). This study supports the implementation of a 5-minute heads-up policy in the emergency department to maximize the utilization of CT scanners.