PICTURE ARCHIVING COMMUNICATION-SYSTEM DOES NOT DECREASE THE NUMBER OF RADIOGRAPHS NEEDED TO EVALUATE THE TRAUMA PATIENT

Background: Picture Archiving Communication System (PACS) is a sophist icated software and hardware package that enables clinicians to retrie ve. review, and digitally manipulate radiographs from computer worksta tions throughout the hospital, PACS was instituted at Brooke Army Medi cal Center in July 1993. Methods: Fifty consecutive trauma and 50 cons ecutive motor vehicle crash (MVC) trauma admissions to an urban trauma center were reviewed before PACS (January 1993) and 18 months after P ACS was instituted (January 1995). Patients were compared by the numbe r of radiographs needed during the initial evaluation by type and tota l. The trauma groups were subdivided by mechanism and also compared. D emographic and physiologic data were collected for each patient. Resul ts: There are no differences in the demographic and physiologic data b etween groups. For the 50 consecutive trauma admissions, only two area s of statistical difference were found: more chest films were obtained in the MVC PACS group and more pelvis films were obtained in the guns hot wound pre-PACS group, For the 50 consecutive MVC trauma admissions , the PACS group had more chest and total radiographs per patient than the pre-PACS group. More computed tomographic scans of the neck were obtained in the PACS group. Conclusion: PACS did not decrease the numb er of radiographs needed to adequately and fully evaluate the trauma p atient.