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Hospital Healthcare Europe

Digital radiography on the trauma frontline

Aoife Lynch
1 January, 2008  

Aoife Lynch
Contributing Editor
Hospital Healthcare Europe

Shortly after a radiology service revamp, as part of a new hospital build, the new state-of-the-art direct digital radiography (DR) systems had their first major test. The 7th July terrorist attacks in central London, targeting tube lines and buses, resulted in several hundred injuries. University College Hospital (UCH) was on the trauma frontline.

The newly installed mobile direct digital “Mobile DaRt” immediately motored into action, being used for extremity imaging of walking wounded and in conjunction with DR systems in the resuscitation bays where the more seriously injured were treated. The use of the mobile DR system facilitated immediate patient management based on instant digital images. This allowed a smooth and efficient throughput of walking wounded patients at a time of high departmental pressure.

Mobile DaRt is a state-of-the-art, motor-driven direct-DR system incorporating a large-area Canon CXDI-50C portable flat-panel detector. This is an 800-speed, 35 x 43 cm, single-tile, direct-DR detector, featuring a very high detective quantum efficiency (DQE) and a 160 µpixel pitch for significantly reduced patient dose and excellent image quality.

The detector weighs just 4.8 kg, an important manual handling factor when selecting a direct-DR mobile X-ray unit, as it is more than 30% lighter than some other products. The detector’s magnesium frame and low-attenuation carbon fibre front panel can support a 150 kg load and so may even be used for standing weight-bearing views.
 
Instant images for immediate assessment
On a daily basis, the use of DR at UCH greatly speeds up the throughput of trauma patients. Examinations are swift, with high-definition digital images produced three seconds after exposure. The immediacy of images enables trauma assessment teams to act instantly on the clinical information. For example, doctors can manipulate fractures in the room as the immediate images allow more accurate reductions. Also, imaging in-situ in the resuscitation rooms, rather than patient transfer to dedicated X-ray rooms, accelerates diagnosis and treatment plans.

“DR has changed the way the hospital handles trauma patients by increasing our multidisciplinary approach and improving working relationships within the accident and emergency unit,” said Victoria Riley, A&E superintendent radiographer at UCH. “X-ray images are produced so quickly and without processing delays that the trauma team now often decides to travel to the X-ray room with the patients. Once there, with images displayed on screens, retakes can be immediately undertaken and additional image views can be chosen. This is a much swifter way of doing things than returning to the X-ray room at a later time.”

A more relaxed patient
The prompt examinations via DR have also delivered benefits directly to the patient. Digital images deliver shorter waiting times, quicker diagnosis and fewer repeats, resulting in lower levels of patient anxiety. This makes interacting with the patient a much smoother and positive process for staff.

Paediatric assessments using DR are also greatly improved. The quicker examinations are much less traumatic to a child who is afraid and in pain.

Patients are also relieved not to have to carry film packets to and from examinations anymore and are impressed at how little time their imaging examinations now take. By the time they get back to the clinic, the images are already available for doctors to view.
 
Departmental morale enhanced
“Radiographers enjoy working with the DR equipment,” said Fiona Henderson, lead superintendent radiographer at UCH. “The rapport between staff and patient is more tranquil, making working life more enjoyable. The equipment upgrade has been valuable for patient relations, and it is also an added asset for recruitment and retention – radiographers are keen to work with the latest technology.”

Digital images produced by the DR systems are archived to picture archiving and communication systems (PACS), which mean fewer administrative tasks such as sorting, coding and filing. Lost films are a thing of the past, and storage areas have been freed up by eliminating cassettes and film.

The wider benefits
The benefits experienced by the patient and radiographers also impact on the department and hospital as a whole:

  • The speed of examinations, reduced repeats and increased patient throughput deliver a reduction in waiting times.
  • Modern techniques deliver instant diagnostic quality results, leading to swifter clinical treatment plans.
  • Departmental teamwork and staff morale are enhanced.
  • The latest technologies and techniques position the hospital positively in an increasingly competitive health environment.

With modern technologies in place and benefits delivered, management within the trust has an enhanced service offering to present to local residents and the feeder primary care trusts.

The introduction of DR imaging systems, including motor-driven mobile units, has delivered a raft of clinical and process benefits. The instant imaging and quicker delivery of X-rays is an improvement on computed radiography; staff enjoy working with modern technology; examination techniques are enhanced; and patient satisfaction is improved. In the battle to meet targets and improve service efficiency, DR is a valuable asset for frontline diagnostic imaging.