A double-edged sword: the effect of technological advancements in the management of neurotrauma patients

Abstract

Introduction: Despite South Africa’s rapidly growing population, the number of patients evaluated by our trauma unit remains static. However, after presentation, increased delays in time to surgery is an issue. With a vast array of technological advancements having been implemented since 2008 at our institution, a clear problem exists at some stage of the patient management process. The aim of this study is to evaluate the efficacy of the management of neurotrauma patients and determine whether there is an association with technological advancements.

Methods: An ambispective study was performed to assess the management of neurotrauma patients. A comparative timeline of 7 months (1 January to 31 July 2007 retrospectively and 1 January to 31 July prospectively 2015) was chosen to evaluate several parameters involved in the management of the neurotrauma patient and the factors affecting these. The year 2007 was chosen as this is the last year prior to implementation of technological improvements.

Results: The demographics, age group and gender of the respective patient populations was remarkably similar. There was more rapid emergency medical service dispatch and hospital transfer in 2015. The time taken for a patient to get to computed tomography (CT) scan has increased and as has the time period between CT scanning and neurosurgical consultation. Time to ultimate neurosurgical intervention after referral, however, has decreased over the years.

Conclusion: One of the greatest sources of delay to surgical management seems to be due to delays in CT scanning where inappropriate prioritization of cases occurs as a result of abuse of the booking and lack of human decision-making and triage. Similarly, after hours needs are not being met with current CT services. As a result of the restriction of human involvement in terms of reviewing scan requests and results there are delays to the neurosurgical service.

Keywords:

• Effect
• neurotrauma
• technological advancements

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.