RESUMO
OBJECTIVES: To compare time metrics associated with a temporary disruption to ED computed tomography (CT) scanner location from adjacent to the ED with direct access from resuscitation rooms, to a location remote to the ED. METHODS: A retrospective before and after study was conducted in a public metropolitan ED with over 66 000 presentations annually. Time-to-CT metrics, operational time metrics and ED length of stay were extracted and analysed from presentations between October 2020 and January 2021. RESULTS: There were 3031 CT scans during the study period. Overall, the disruption was associated with a significant 27-36 min delay (P < 0.01) in time-to-CT start; these delays were also observed in a subset of trauma patients. In a subset of presumed stroke patients, time-to-brain perfusion was significantly delayed by up to 10 min (P < 0.01). There was a 14% (P < 0.01) greater demand for operational services and a time imposition of up to 8 min (P < 0.01) to transport patients to or from CT scanning when the CT scanner was located away from the ED. ED length of stay was consistent at all time points. CONCLUSION: Although rapid, proximate access to CT scanning is often considered desirable in terms of the management of trauma and other time-critical emergencies, the wider time and resource implications demonstrated in this study suggest a potential broader benefit to co-located CT scanning in ED. Our experience could be considered in future re-design of EDs.
