This has been quite informative, and the original topic of the tread has changes somewhat. I am getting the impression you are all pro an ATLS CT survey.
I can see the argument against the statscan rests on the need for a 'brain attack' service, which needs a CT anyway. But please don't fall into the trap of calling ALL CT examinations "a CT". That's like saying ALL operations are "an operation" and any surgeon can perform "an operation".
We are currently rewriting our radiography course documentation. Currently, a radiographer fresh out of university with their degree and HPC registration will have been trained and assessed as competent in performing just one CT examination - the CT head scan. This was recently added to the HPC standards of proficiency we all have to sign to say we meet every 2 years. Because of this, a 'brain attack' approach will be perfectly possible to envisage in the next wee while. But this 'oh while you are there can you do x, y, and z, CT scans...' Just isn't going to happen unless their is some serious service redesign and a change in training.
Do you think we should be preparing them to be able to do a full CT survey within the next 5 years? The normal way to cover this additional CT service is with an on call from home service - but this would violate your 'golden hour'. I suppose the CT head could be being done while the on call from home radiographer made their way in to conduct the rest of the scans... If you want a 'in the hospital' CT radiographer, my experience suggests you need a minimum of 16 CT radiographers trained to run this rota (This is additional to the other CT rotas, e.g. neuro department etc.) AND they need enough practice to maintain their competencies.
What do you want scanning? can you envisage what a CT survey would comprise of? is it head, neck, chest and pelvis? Are you wanting 3D reconstruction of these areas, or a slice every 1cm as a survey?
My interest is in training, specifically in simulation - this looks like a good area for a CT simulator that students can train on, and can revalidate themselves on periodically. Anyone interested in putting in a bid for some funding so we can get a prototype up and running?
Philip
________________________________
From: Accident and Emergency Academic List on behalf of Martyn Hodson
Sent: Wed 2/6/2008 22:06
To: [log in to unmask]
Subject: Re: Resus gantries / DR
> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]] On Behalf Of Cosson, Philip
> Sent: 06 February 2008 14:19
> To: [log in to unmask]
> Subject: Re: Resus gantries / DR
>
>
> Forgot to say...
>
> The statscan is manufactured by a small company in south
> africa with a tiny marketing budget. CT scanners on the other
> hand are manufactured and marketed by Siemens, GE, Philips
> and Toshiba who have a rather large combined marketing
> budget. Several university hospitals in europe and the US are
> basically 'owned' by these companies. Publications are
> expected demonstrating favorable outcomes from high cost technology.
>
> Surely there are higher priority uses of circa 1 million quid
> capital and the additional recurring staff costs than
> putting a CT scanner in every resus? How many patients are
> dying due to the delay in getting a scan at the moment? If i
> was a lay member on a trust board, i would need some convincing.
>
> Philip
But given the next big thing is / will be the 'brain attack' approach
(and no doubt a CVENAP to mirror the experience with MIs ) approach to
strokes or what may appear to be strokes ... Suddenly the CT scanner In
the resus room doesn't look quite as out of place, and if we are
workforce planning for radiology to be able ot provide CT for 'brain
attacks' in a tight time frame Emergency Dept radiographers will be
working full shifts to provide both the traditional plain film service
and the 'brain attack' and 'trauma' CT service....
particularly in new builds with the 'critical clinical adjacencies' for
emergency medicine, acute medicine and critical care ... Iwith ED,
Acute Assessment Unit, CDU and critical care beds (CCU, HDU, ITU, NIV)
clustered geographically over one or two floors
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