□ Fig. 6.16. Case study of a trauma patient (conservative). Manual transfer of the patient is necessary up to 10 times (Kantonsspital Basle, CARCAS Group)
first aid and transport, this period is still considerable in view of the subsequent time taken up by diagnostic measures in hospital until an operation can start. Manual patient transfers are still common practice today and take up a great deal of time, which could otherwise go to looking after the patient. Between arrival in the emergency room and the start of surgical procedures, it is not rare for the patient to be repositioned or transferred more than eight to ten times, taking about 10 min every time (O Fig. 6.16).
On the one hand, the use of the AWIGS system considerably reduces the physical burden on the operating staff. On the other hand, the time savings are particularly beneficial for patients whose injuries have not been diagnosed yet. If there are only 2 instead of 4 h between accident and operation, the lethality1 of the polytrauma is reduced by 70%.
In future, therapeutic procedures with AWIGS can be faster, safer and gentler. Diagnosis, operation and control are grouped together in one integrated surgical workstation. The use of CT in traumatology offers a 70% improved therapy decision for the polytrauma. Another advantage of this concept is the drastic reduction in risky repositioning for the patient which always ties up corresponding personnel resources.
The traumatised patient is only transferred twice in the hospital: from the ambulance or helicopter onto a special, radiolucent surface of carbon fibres (CRP), the so-called transfer board which is multifunctional for the system components patient transporter, operating table and computed tomography. The patient now stays on this transfer board from imaging diagnosis and initial care in the shock room through to the operation, until the emergency care is completed and it is time to transfer the patient to a bed in intensive care. The number of manual repositioning tasks or patient transfers for a polytrauma is reduced by up to 80% (O Fig. 6.17).
The AWIGS/VIWAS transfer board is placed on the emergency transporter. The various positions include raised back, adjusted height, Trendelenburg adjustment and length adjustment; in addition, the emergency transporter offers optimised radiolucency in the anteropos-terior direction (O Fig. 6.18).
This means that initial diagnosis of the trauma patient can be carried out on the transporter. To this end, it is equipped with adapters for monitoring and therapy units on lateral rails. The design of the transporter not only allows for use of a C-arm but also for conventional X-rays. The board surface of the patient transporter is radiolu-cent. X-ray cassettes can be pushed into the guide rails under the board surface.
Trauma concept 1: »one stop shop« -everything in one room
If a CT scan is required for further diagnosis, the patient is brought to a multifunctional room where the CT is installed with the AWIGS duplex column operating table and CT table. The patient transporter is coupled to the AWIGS operating table. The transfer board on the patient transporter is pushed (with the patient on it) onto the operating table. Further transport from the operating table to the CT is automatic with push-button control. A whole-body scan is possible for body heights of up to
1 The lethality rate is the relationship between the number of those who have died due to a specific disease and the number of new cases. (It only makes sense to determine this ratio in cases of acute disease.) Cf. mortality.
□ Fig. 6.17. Case study of a trauma patient with AWIGS. With AWIGS, manual transfer of the patient is only necessary on arrival and after treatment
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