Images in clinical medicine. Air embolism after the insertion of a central venous catheter.
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Biomedical subjects
Publications and source records attributed to Ulf K M Teichgräber.
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OBJECTIVE: We report on the use of portable computed tomography (CT) in an ICU setting. The additional diagnostic gain and therapeutic consequences were assessed. PATIENTS: Ten ICU patients underwent 14 portable chest CT examinations. In 64% maximum intensive care was required, according to TISS28 (>40), and 42% were at a risk of mortality higher than 25% (MODS) on the day of portable CT examination. In three portable CT examinations the patients were considered not transportable and were examined directly in the patient room. All other examinations were performed in a special interventional suite directly on the ICU. RESULTS: Of 14 examinations 8 (57%) resulted in a change in patient management within 48 h. All patients profited from portable CT and no hazards occurred related to CT. CONCLUSIONS: To perform portable CT in the interventional suite on the ICU allows immediate minimally invasive therapeutic interventions and provides full ICU monitoring.
In the face of increasing financial pressure on our health care system, one way to reduce costs while maintaining or even improving outcome quality is to improve work flow efficiency. Network Planning Technique (NPT) is a tool for mapping and analyzing work flows. Designing a network plan requires four steps. Step 1 is concerned with the determination of the work flow structure. Step 2 deals with data acquisition. Based on the data retrieved a network plan is created in Step 3. Step 4 includes the calculation of the critical path and slack times under optimistic, realistic and pessimistic conditions. Applied to the ultrasound division in our department a total examination time of 34:14 minutes was calculated with 23:09 minutes total slack time for the technician under realistic conditions. Using NPT creates transparency in work flows and allows us to estimate resource demands. A comparison between two different divisions with a similar work flow structure but different resource allocation demonstrates this method's potential for improving work flows. Limitations of the NPT can be noted when considering cycle overlap in repetitive work flows and modeling non-regular activities.