Mobile computerized tomography scanning in the neurosurgery intensive careunit: increase in patient safety and reduction of staff workload

Object. Transportation of unstable neurosurgical patients involves risks th at may lead to further deterioration and secondary brain injury from pertur bations in physiological parameters. Mobile computerized tomography (CT) he ad scanning in the neurosurgery intensive care (NICU) is a new technique th at minimizes the need to transport unstable patients. The authors have been using this device since June 1997 and have developed their own method of s canning such patients. Methods. The scanning procedure and radiation safety measures are described . The complications that occurred in 89 patients during transportation and conventional head CT scanning at the Department of Radiology were studied p rospectively. These complications were compared with the ones that occurred during mobile CT scanning in 50 patients in the NICU. The duration of the procedures was recorded, and an estimation of the staff workload was made. Two patient groups, defined as high- and medium-risk cases, were studied. M edical and/or technical complications occurred during conventional CT scann ing in 25% and 20% of the patients in the high- and medium-risk groups, res pectively. During mobile CT scanning complications occurred in 4.3% of the high-risk group and 0% of the medium-risk group. Mobile CT scanning also to ok significantly less time, and the estimated personnel cost was reduced. Conclusions. Mobile CT scanning in the NICU is safe. It minimizes the risk of physiological deterioration and technical mishaps linked to intrahospita l transport, which may aggravate secondary brain injury. The time that pati ents have to remain outside the controlled environment of the NICU is minim ized, and the staff's workload is decreased.