Improved emergency activation in interventional radiology reduces procedure delay and facilitates treatment success in patients with acute arterial bleedings

• Published in: PloS one 2024-11, Vol.19 (11), p.e0313008
• Main Authors: Nadjiri, Jonathan, Mühlmann, Marc, Waggershauser, Tobias, Geith, Tobias, Paprottka, Philipp M
• Format: Article
• Language: English
• Subjects: Activation analysis; Adult; Aged; Aged, 80 and over; Algorithms; Angiography; Angiography - methods; Biology and Life Sciences; Bleeding; Care and treatment; Causes of; Cellular telephones; Communication; Complications and side effects; Computed tomography; Consent; CT imaging; Data acquisition; Diagnosis; Emergency management; Emergency procedures; Emergency response; Ethics; Female; Fluoroscopy; Hemorrhage; Hemorrhage - therapy; Human error; Humans; Intervals; Intervention; Male; Medical colleges; Medical diagnosis; Medical research; Medicine and Health Sciences; Medicine, Experimental; Middle Aged; Patient outcomes; Patients; People and Places; Physicians; Radiation; Radiation dosage; Radiology; Radiology, Interventional; Radiology, Interventional - methods; Radiology, Medical; Research and Analysis Methods; Retrospective Studies; Success; Time-to-Treatment; Tomography, X-Ray Computed - methods; Treatment Outcome; Working hours
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0313008

Research of interventional treatment success in arterial bleeding cases is almost exclusively focused on technical and procedural factors. This study investigates the effect of an improved preprocedural activation algorithm for acute arterial bleedings treated by interventional radiology. During the three-year study period (2018-2021), the authors implemented an always-reachable, simple-to-remember emergency phone number routed to the responsible interventional radiologist on call and compared this pathway to the previous activation process. Data were acquired for all emergency cases with active arterial bleeding detected in CT scans and the diagnosis to treatment intervals before and after implementation were retrospectively analysed. Time signatures in CT and angiography were used to determine the interval. 1322 calls or contacts occurred during the study period. In general, 625 emergency procedures were conducted; 120 bleeding interventions met the study requirements. In the study 44 patients were treated via the conventional pathway and 76 via the emergency phone activation. The activation algorithm utilizing the emergency phone led to a slight decrease in radiation doses and fluoroscopy time and a significant reduction (15min) in diagnosis to treatment intervals (p = 0.019). After implementing the emergency phone, the technical success rate increased significantly from 68% to 94% (p