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Initial Experience with Mobile CT in Initial Experience with Mobile CT in Neurosurgery ICU in a Level I Trauma Center In Neurosurgery ICU in a Level I Trauma Center In

IndiaIndia

Shallu Chauhan, Deepak AgrawalShallu Chauhan, Deepak AgrawalDepartment of Neurosurgery, JPNATC, AIIMS, N DelhiDepartment of Neurosurgery, JPNATC, AIIMS, N Delhi

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BackgroundBackground

Neurosurgical patients, particularly of severe head injury require frequent CT’s of the head, usually at short notice. A mobile CT may prove to be invaluable for these patients.

Shifting of severe head injury patient is

problematic because it connects to multiple I\V lines and drains.

Background

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AIMS & OBJECTIVESAIMS & OBJECTIVES

To Review the To Review the usefulness of usefulness of mobile CT in mobile CT in Neurosurgery ICU Neurosurgery ICU with particular with particular reference to reference to nursing care.nursing care.

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MATERIALS AND METHODSMATERIALS AND METHODS

This was a prospective study carried out This was a prospective study carried out over fourteen month period (18 July over fourteen month period (18 July 2009 till 31 August 2010) at JPNATC 2009 till 31 August 2010) at JPNATC AIIMS.AIIMS.

Administrative and clinical data was Administrative and clinical data was reviewed and analyzed.reviewed and analyzed.

MATERIALS AND METHODSMATERIALS AND METHODS

For the first 6 months only the number For the first 6 months only the number of CT’s done was available.of CT’s done was available.

However, data was collected However, data was collected prospectively w.e.f 1 Jan 2010 to include prospectively w.e.f 1 Jan 2010 to include variables like GCS ventilator status, and variables like GCS ventilator status, and pressor support (dopamine and nor-pressor support (dopamine and nor-adrenaline) at the time of CT scan.adrenaline) at the time of CT scan.

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MATERIALS AND METHODSMATERIALS AND METHODS

The number of personnel involved and The number of personnel involved and the time required to do a mobile CT and the time required to do a mobile CT and a conventional CT was also recorded for a conventional CT was also recorded for 10 patients in each group.10 patients in each group.

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RESULTSRESULTS

The mobile CT was The mobile CT was installed and became installed and became functional in functional in Neurosurgery ICU on Neurosurgery ICU on 18 July 2009.18 July 2009.

17521752 Head CT’s were Head CT’s were done during the study done during the study period with an average period with an average of 4.78 CT’s daily. of 4.78 CT’s daily.

Detailed prospective data was available (since 1 Detailed prospective data was available (since 1 january 2010) on 563 patients at the time of january 2010) on 563 patients at the time of C.T.Scan in I.C.U.C.T.Scan in I.C.U.

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TOTAL % OF PT.’S ON VENTILATOR

TOTAL % OF PT.’S ON SEDATION

TOTAL % OF PT.’S ON PRESSOR SUPPORT

MEAN G.C.S[Range 3 to15]

76% 72% 6% 8.09

Conventional CTConventional CT

Average time to do a conventional CT (From Average time to do a conventional CT (From ordering to return of the patient on bed) was ordering to return of the patient on bed) was 150 minutes (range 60 to 240 minutes)150 minutes (range 60 to 240 minutes)

The mean number of people required for The mean number of people required for shifting the patient were 4 (range 3 to 6). shifting the patient were 4 (range 3 to 6).

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Mobile CTMobile CT

The average time to do a CT was 27.4mins.The average time to do a CT was 27.4mins.

Mean manpower required was 3 (range 3 to Mean manpower required was 3 (range 3 to 4).4).

As compared to conventional CT significantly As compared to conventional CT significantly less time (p<0.001) and manpower (p<o.o1) less time (p<0.001) and manpower (p<o.o1) were required for mobile CT.were required for mobile CT.

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Type of CT Average time(mins.)

Mean number of people

Conventional CT 150 4

Mobile CT 27.4 3

Video of mobile C.T. SCANVideo of mobile C.T. SCAN

TAKEN IN I.C.UTAKEN IN I.C.U..

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CONCLUSIONSCONCLUSIONS Mobile CT was found to be extremely useful for Mobile CT was found to be extremely useful for

neurosurgery department and was found to be very neurosurgery department and was found to be very easy to use, with fast scanning time and excellent easy to use, with fast scanning time and excellent image quality.image quality.

It is very beneficial for the nurses as it requires less It is very beneficial for the nurses as it requires less time , energy and work.time , energy and work.

Nursing careNursing care is greatly improved as patient does not is greatly improved as patient does not have to be shifted from his/her ICU bedhave to be shifted from his/her ICU bed..

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Overall the mobile CT improves patient care by Overall the mobile CT improves patient care by providing fast scanning with early diagnosis and providing fast scanning with early diagnosis and timely proper management.timely proper management.

The mobile CT is strongly recommended for any The mobile CT is strongly recommended for any high volume neurosurgery department in the high volume neurosurgery department in the countrycountry..

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THANKTHANK YOU YOU