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ED: Nuevas tecnologías y programas para el ambiente del cuidado médico que cambia

por Lauren Dubinsky, Senior Reporter | December 11, 2014
Emergency Medicine
From the December 2014 issue of HealthCare Business News magazine


Today, in most large hospitals, there will be a CT both in the radiology department and the ED.

Two of Siemens’ CTs — SOMATOM Definition Edge, which got FDA approval in 2012, and SOMATOM Force, which got approval earlier this year — have found a place in some hospitals’ EDs. Physicians in the ED are more likely to perform more image reconstructions than in other settings because they usually don’t have any information on the patient’s condition. The Definition Edge was designed with refined image reconstruction so it can provide the physician with more of that information.

Most CT take upwards of 10 seconds to image a patient but the Force is capable of performing sub-second scans. That generates better image quality when scanning patients who are unconscious or confused and aren’t able to follow breathing instructions. GE Healthcare’s Revolution CT, which received FDA approval in April, is another unit designed to diagnose challenging patients in the ED. It also reduces breath hold times because it can scan entire organs including the brain, heart, liver and pancreas in one .28 second rotation.

It can acquire a scan of the heart in one beat even at high heart rates because of its wide area 160 millimeter coverage detector and new cardiac protocols available on the GE’s Clarity user interface.
The system also has built-in software called SnapShot Freeze that can capture coronary motion independent of gantry rotation speed so the physician can image the heart motion free.

Changing protocol
The biggest challenge that the physicians at Beaumont Health System in Michigan face is the volume of patients that come into their ED. Over the past three months, they have seen a record high number of patients admitted.

“These volumes are going up, we’re seeing sicker and sicker patients and the hospital has been full for quite some time,” said Dr. Terry Kowalenko, chief of emergency medicine at Beaumont. “Obviously, we have a challenge of getting our patients who are admitted upstairs.”

In an effort to solve the problem, Beaumont is going to convert some of their office space into hospital beds and they are also working on creating a discharge lounge area so that patients won’t have to wait in their rooms for a ride.

Beaumont doesn’t know the reason why they have seen a recent increase in ED volume, but it’s not something that’s just isolated to their health system.

About 25 percent of patients who go to the ED don’t need to be there, according to a Medicare Payment Advisory Committee report from 2012. Since many of them don’t have primary care doctors, they are using the ED are their drop-in clinic.

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