Improving CT scanner efficiency for trauma team activations in the emergency department.

BACKGROUND AND OBJECTIVES: A Trauma Team Activation (TTA) is initiated when a patient has sustained a life or limb-threatening injury thereby necessitating resources of a large care team. Previously, a CT scanner was cleared at the time of the prehospital TTA call. Wide variability in the time it took to stabilize patients often led to extended CT scanner idle time. A new policy was developed whereby the team leader would prompt the ED clerk to provide a '5-min heads-up' (5-min HU) notification to the CT scanner personnel as a patient was stabilized. At this point, the CT scanner was cleared. The purpose of this quality improvement project is to evaluate if the new policy saves CT scanner idle time. METHODS: Research interns prospectively followed incoming TTAs in the ED of a large, urban, Level I Trauma Center in November 2022. The interns collected the following time points: TTA notification page, 5-min HU notification, and arrival to CT. Data was analyzed using a non-parametric comparison test (Mann-Whitney U). RESULTS: A convenience sample of 46 TTAs was included. Trauma was blunt (85%; n = 39)) and penetrating (15%; n = 7). The median initial TTA announcement to CT arrival time was 24.0 min (IQR: 9.0 min). Previously, the scanner would have been held for this entire period. The median time from 5-min HU notification to CT arrival was 5.0 min (IQR: 4.0 min). The new policy saved a median of 19 min of CT scanner idle time per patient compared to the old policy (p < 0.0001). The total CT scanner time saved was 818 min (13.6 h). CONCLUSION: These data support the implementation of a 5-min HU policy in the ED for patients arriving as TTAs. This maximizes the availability of CT scanners for other patients in the ED while TTA patients are being stabilized.

Attitudes Toward Animal Research Among Medical Students in the United States.

Prior to use in patients in the clinical setting, the safety, mechanism of action, and efficacy of new treatments must be established. This often requires testing new treatments in animals. Public attitudes toward animal research have been investigated, but less is known about the attitudes of physicians. To begin to address this, we examined attitudes of medical students regarding animal research, and whether these attitudes were rigidly held. We surveyed US-based student members of the American Academy of Neurology (AAN). Students were questioned regarding agreement or disagreement with a set of 14 positively- or negatively-biased statements regarding animal research. To determine if these attitudes were rigidly held, students viewed an educational video regarding animals used in research and repeated the survey immediately after the video. One hundred sixty-eight students completed the initial survey. A group attitude score was calculated based on agreement with 14 statements. Males and those with previous research experience had a significantly more positive attitude toward animal research, but other variables had no effect. After viewing the video, 108 students repeated the survey. The overall attitude of respondents changed to be significantly more positive toward animal research. Of the 14 statements, attitudes toward 7 individual statements became significantly more positive after viewing the video. To our knowledge, this is the first study to examine attitudes toward animal research among medical students. Overall, the group's attitude toward animal research was more positive than negative. However, these negative attitudes do not appear to be rigidly held. These findings should be considered in the future of medical education curriculum development.