scholarly journals Full-Body X-Ray Imaging to Facilitate Triage: A Potential Aid in High-Volume Emergency Departments

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
S. P. Whiley ◽  
H. Alves ◽  
S. Grace
Keyword(s):  
South African ◽  
Emergency Departments ◽  
Clinical Decision Making ◽  
Traumatic Injury ◽  
High Volume ◽  
Trauma Centre ◽  
Trauma Patients ◽  
X Ray ◽  
X Ray Imaging ◽  
Full Body

The levels of traumatic injury seen in South African emergency departments (EDs) are epidemic. This is coupled with a severe lack of resources and adequately trained emergency staff. The Lodox Statscan (LS) is an X-ray scanner capable of producing rapid, low-dose, and full-body X-ray images. In this paper, a new trauma protocol—the Johannesburg trauma protocol—that implements LS scanning on entry to the ED as a triage tool is reported. A case study illustrating the use of LS to triage 63 patients in a single Saturday shift at a level 1 Trauma Centre is also presented. Because of the ability to rapidly and safely provide X-ray imaging information to support clinical decision making, the LS could be a useful tool to aid in resource allocation to improve treatment of the high levels of trauma patients that present to South African EDs daily.

An investigation into the extent of Lodox imaging usage in South Africa: Radiographer’s perspective

2021 ◽  
Author(s):  
Julius Muchui Thambura ◽  
Jeanette G.E du Plessis ◽  
Cheryl M E McCrindle ◽  
Tanita Cronje
Keyword(s):  
South Africa ◽  
Waiting Times ◽  
Cross Sectional Study ◽  
Trauma Patients ◽  
X Rays ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Imaging Protocol ◽  
X Ray ◽  
X Ray Imaging

Abstract Introduction Anecdotal evidence suggests that medical professionals in trauma units are requesting additional regional images using conventional x-ray systems, even after trauma patients have undergone full-body Lodox scans. Patients are then exposed to additional radiation, additional waiting times and an increased medical bill. This study aimed at investigating the extent to which Lodox systems were used in trauma units (n=28) in South Africa. Method In this descriptive cross-sectional study, the researcher invited one radiographer from the 28 hospitals in South Africa that use Lodox systems. Radiographers who were most experienced in using the Lodox system completed an online questionnaire. Results Twenty (71.43% n=20) out of twenty-eight radiographers responded. Most hospitals (90%, n=18) were referring patients for additional conventional x-ray images. Radiographers indicated that conventional x-rays were requested for the chest (27.80%, 10/36), the abdomen (16.67%, 6/36), the spine (13.89%, 5/36) and the extremities and skull (19.44%, 7/36). Additionally, radiographers reported using Lodox to perform procedures and examinations usually performed on conventional x-ray systems when conventional x-ray systems were not operational. Conclusion Currently, it is not clear if the use of conventional x-ray imaging following Lodox is necessary, but the results suggest that the practice is commonplace, with healthcare workers in most hospitals (90%, n=18) requesting additional x-ray imaging. The researcher thus recommends that an imaging protocol for Lodox imaging systems should be developed to guide the referral of the patients for further imaging.

scholarly journals EP.WE.105Hand trauma during COVID pandemic: a tertiary trauma centre experience

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Amir Ghareib ◽  
Sylwia Oniska ◽  
Laura Karran ◽  
Jamil Moledina
Keyword(s):  
High Volume ◽  
Trauma Centre ◽  
Active Movement ◽  
Trauma Patients ◽  
University Hospitals ◽  
Hand Fractures ◽  
Good Movement ◽  
Hand Fracture ◽  
June July

Abstract Introduction St. George’s University Hospitals NHS Foundation Trust is a tertiary trauma centre. We receive a high volume of hand referrals from all over the south West London region. Closed hand fractures represent a significant number of our referrals. COVID-19 has put more burden in all health service endangering poor management of these trauma patients. Aim To assess management of close hand trauma patients during COVID pandemic. Methods Retrospective evaluation of closed hand fracture referrals during June, July, and August 2020. Clinical documentations, operative details and follow up visit notes have been reviewed. Results 106 patients have been included. 47 patients treated surgically with 81% of them were in need for metalwork insertion. Most of operations were done within 8 days. Number of hospital visits was variable with a mean of six days for adult and two days for children. Patient who was in need for hand therapy have been seen within the first 8 days of their surgery. At three months follow up, only three cases had infection. Only one case had osteomyelitis and the other two case had infected metalwork. Most of the patents reported good movement in ASSH Total Active Movement of Hand score (TAM) at the end of the three months. Conclusion Despite COVID 19 pandemic our service managed to achieve acceptable results in dealing with these cases. Yet, securing a reasonable number of operating sessions and clinic appointments remains a challenge.

scholarly journals Cervical Spine Computed Tomography Imaging Artifact Affecting Clinical Decision-Making in the Traumatized Patient

2014 ◽  
Vol 8 (1) ◽  
pp. 372-374 ◽  
Author(s):  
Aaron C Coats ◽  
Matthew S Nies ◽  
David Rispler
Keyword(s):  
Computed Tomography ◽  
Decision Making ◽  
Cervical Spine ◽  
Clinical Decision Making ◽  
Ct Scanning ◽  
Clinical Decision ◽  
Trauma Patients ◽  
Advanced Imaging ◽  
X Ray ◽  
Ct Artifact

CT scanning is an important tool in the evaluation of trauma patients. We review a case involving a trauma patient in which a cervical spine computed tomography (CT) artifact affected decision-making by physicians. The CT artifact mimicked bilateral dislocated facets (51-B1.1). On the basis of CT findings, the patient was transferred to a different hospital for evaluation. Discrepancy between the primary CT scan and patient physical exam prompted secondary CT scans and X-ray evaluation; neither of these studies showed osseous abnormalities. This case reinforces the necessity for physicians to formulate their diagnosis based upon multiple areas of information including physical examination, plain x-ray and subsequent advanced imaging, rather than relying solely on advanced imaging.

scholarly journals Initial free cortisol dynamics following blunt multiple trauma and traumatic brain injury: A clinical study

2019 ◽  
Vol 47 (3) ◽  
pp. 1185-1194
Author(s):  
T Kusmenkov ◽  
M Braunstein ◽  
HJ Schneider ◽  
M Bidlingmaier ◽  
WC Prall ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Multiple Trauma ◽  
Repeated Measures ◽  
Traumatic Injury ◽  
Trauma Centre ◽  
Trauma Patients ◽  
Total Cortisol ◽  
Free Cortisol ◽  
Multiple Trauma Patients

Objective To determine free and total cortisol serum concentrations in the first 24 h after trauma and to evaluate the influence of traumatic brain injury (TBI) on their dynamics. Methods This prospective cohort study enrolled patients who had experienced multiple trauma and were admitted to a level 1 trauma centre. The patients were divided in two groups based on the presence of TBI according to clinical and radiological findings. Blood was collected initially as well as at 12 h and 24 h after the traumatic injury. Total cortisol, corticosteroid binding globulin (CBG) and free cortisol levels were determined. Results The study analysed data from 49 patients (36 males and 13 females) with a mean ± SD age of 45.0 ± 16.0 years. Of these, 36 presented with TBI and 13 had multiple injuries without TBI. Patients with TBI showed significantly lower concentrations of total cortisol and free cortisol compared with patients without TBI. Repeated measures analysis revealed different concentration dynamics in patients with TBI, with no increase in cortisol after trauma. Conclusion Multiple trauma patients with TBI are at risk of acute impaired cortisol secretion and show an attenuated stress response as early as 12 h after injury.

Use of a full-body digital X-ray imaging system in acute medical emergencies: a systematic review

2014 ◽  
Vol 33 (2) ◽  
pp. 144-151 ◽  
Author(s):  
Lei Yang ◽  
Li-gang Ye ◽  
Jian-bo Ding ◽  
Zhong-jun Zheng ◽  
Mao Zhang
Keyword(s):  
Systematic Review ◽  
Imaging System ◽  
X Ray ◽  
X Ray Imaging ◽  
Medical Emergencies ◽  
Full Body

Defects of Platelet Function Recognized by X-Ray Imaging and Scanning Electron Microscopy

1985 ◽  
Vol 43 ◽  
pp. 610-613
Author(s):  
M.G. Baldini ◽  
S. Morinaga ◽  
D. Minasian ◽  
R. Feder ◽  
D. Sayre ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Cell Biology ◽  
Imaging Technique ◽  
Human Platelets ◽  
X Rays ◽  
X Ray ◽  
X Ray Imaging ◽  
Complex Phenomena ◽  
Scanning Electron

Contact X-ray imaging is presently developing as an important imaging technique in cell biology. Our recent studies on human platelets have demonstrated that the cytoskeleton of these cells contains photondense structures which can preferentially be imaged by soft X-ray imaging. Our present research has dealt with platelet activation, i.e., the complex phenomena which precede platelet appregation and are associated with profound changes in platelet cytoskeleton. Human platelets suspended in plasma were used. Whole cell mounts were fixed and dehydrated, then exposed to a stationary source of soft X-rays as previously described. Developed replicas and respective grids were studied by scanning electron microscopy (SEM).

Designing high-resolution slow scan CCD-based TEM camera systems

1992 ◽  
Vol 50 (2) ◽  
pp. 946-947
Author(s):  
James F. Mancuso ◽  
William B. Maxwell ◽  
Russell E. Camp ◽  
Mark H. Ellisman
Keyword(s):  
Fiber Optics ◽  
Ccd Camera ◽  
High Energy ◽  
Phosphor Layer ◽  
X Ray ◽  
Light Production ◽  
Camera Systems ◽  
X Ray Imaging ◽  
Electron Image ◽  
Scintillating Fiber

The imaging requirements for 1000 line CCD camera systems include resolution, sensitivity, and field of view. In electronic camera systems these characteristics are determined primarily by the performance of the electro-optic interface. This component converts the electron image into a light image which is ultimately received by a camera sensor.Light production in the interface occurs when high energy electrons strike a phosphor or scintillator. Resolution is limited by electron scattering and absorption. For a constant resolution, more energy deposition occurs in denser phosphors (Figure 1). In this respect, high density x-ray phosphors such as Gd2O2S are better than ZnS based cathode ray tube phosphors. Scintillating fiber optics can be used instead of a discrete phosphor layer. The resolution of scintillating fiber optics that are used in x-ray imaging exceed 20 1p/mm and can be made very large. An example of a digital TEM image using a scintillating fiber optic plate is shown in Figure 2.

Ionic homeostasis and subcellular element compartmentation

1990 ◽  
Vol 48 (2) ◽  
pp. 150-151
Author(s):  
Ann LeFurgey ◽  
Peter Ingram ◽  
J.J. Blum ◽  
M.C. Carney ◽  
L.A. Hawkey ◽  
...  
Keyword(s):  
Leishmania Major ◽  
Ionic Homeostasis ◽  
X Ray ◽  
Functional Studies ◽  
Cell Compartments ◽  
X Ray Imaging ◽  
Resolution Electron ◽  
Multiple Cell ◽  
Role Of Zn

Subcellular compartments commonly identified and analyzed by high resolution electron probe x-ray microanalysis (EPXMA) include mitochondria, cytoplasm and endoplasmic or sarcoplasmic reticulum. These organelles and cell regions are of primary importance in regulation of cell ionic homeostasis. Correlative structural-functional studies, based on the static probe method of EPXMA combined with biochemical and electrophysiological techniques, have focused on the role of these organelles, for example, in maintaining cell calcium homeostasis or in control of excitation-contraction coupling. New methods of real time quantitative x-ray imaging permit simultaneous examination of multiple cell compartments, especially those areas for which both membrane transport properties and element content are less well defined, e.g. nuclei including euchromatin and heterochromatin, lysosomes, mucous granules, storage vacuoles, microvilli. Investigations currently in progress have examined the role of Zn-containing polyphosphate vacuoles in the metabolism of Leishmania major, the distribution of Na, K, S and other elements during anoxia in kidney cell nuclel and lysosomes; the content and distribution of S and Ca in mucous granules of cystic fibrosis (CF) nasal epithelia; the uptake of cationic probes by mltochondria in cultured heart ceils; and the junctional sarcoplasmic retlculum (JSR) in frog skeletal muscle.

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