Emergency / STAT reporting is an urgent interpretation on CT, MRI, X-Ray, Ultrasound (USG) etc. used in emergency departments, trauma centers, intensive care units (ICUs), and stroke or cardiac care units. At such places, timely and rapid examination is required to determine the etiology of the emergency. Adequate imaging modalities and skilled radiologists are required to support the treatment.
Unlike the routine radiological reportings, STAT reportings need to be rapid, highly accurate, and effectively communicated. STAT radiologists often communicates verbally with the attending physician to save the time spent on documentation.
The word STAT is derived from the Latin word “statim,” which means “immediately”. STAT reporting refers to the essential medical diagnosis required at the time of emergencies. These are highly crucial, as the availability and accuracy of these results directly impact life-threatening conditions.
Statim Healthcare provides Emergency / STAT Reporting at Night time because, some Hospitals / clinical centers the staffing is minimal and certain resources are unavailable. However, health emergencies can manifest irrespective of time. In such cases, hospitals cannot wait for the working hours to resume. Many cases, such as heart attack, stroke, head injury, internal bleeding, bowel obstruction, or acute chest and abdominal emergencies, require immediate attention. For immediate intervention, imaging modalities, especially those important to detect life-threatening cases, must be functional during the night. Emergency reporting at night enables clinicians to have access to rapid diagnosis, expert radiologist opinions, and prevention of morbidity and mortality.
Some of the most common conditions requiring emergency/STAT reporting are listed below:
Acute neurological conditions are one of the most reported instances during emergency/STAT reporting. These include acute ischemic stroke, intracranial hemorrhage (subarachnoid, intracerebral, subdural, and epidural), traumatic brain injury, acute spinal cord compression, and cerebral edema and hydrocephalus. For these cases, non-contrast CT is the first line of imaging due to its ability to rapidly differentiate hemorrhagic stroke from ischemic stroke. CT angiography and perfusion are used to examine vessel occlusion and salvageable soft tissue. Brain/spine MRIs are useful to detect early ischemia, cord compression, or demyelinating emergencies.
Trauma cases constitute a large chunk of nighttime STAT reporting. These are generally caused by traffic accidents, blunt force injury, polytrauma involving the head, chest, abdomen, and pelvis, and suspected internal hemorrhage. Under a trauma protocol, there is a whole-body CT evaluation to look for injuries in multiple organs. It effectively detects solid organ injury, active bleeding, fractures, and vascular damage. A trauma condition can deteriorate instantly. Timely evaluation determines whether the patient goes to OT, ICU, the angiography suite, or conservative management.
Chest emergencies are often nonspecific and life-threatening. Hence, it is crucial to obtain an imaging evaluation rapidly to determine the cause. Common chest emergencies include pulmonary embolism, aortic dissection, tension pneumothorax, massive hemothorax, and severe pneumonia or ARDS. These conditions can lead to sudden respiratory or circulatory failure. For rapid detection, CT pulmonary angiography, CT angiography, and chest X-rays are some of the preferred imaging modalities.
These classes of emergencies often require rapid surgical interventions. Delay in treatment may result in sepsis, peritonitis, multi-organ failure, or even mortality. Acute appendicitis, bowel obstruction and perforation, mesenteric ischemia, acute pancreatitis with complications, intra-abdominal or pelvic hemorrhage, and ruptured ectopic pregnancy are some of the common abdominal and pelvic emergencies. The most common imaging modality used for such cases is contrast-enhanced CT. Next, ultrasound is useful for gynecologic and pediatric emergencies.
Although not as common as the previously mentioned emergencies in this section, cardiovascular emergencies carry some of the highest risks. These include acute aortic syndromes, cardiac tamponade, major vascular occlusions, and post-procedural vascular complications. CT angiography and echocardiography are modalities of choice for cardiovascular complications.
Apart from the above-discussed complications, critical infections, sepsis-related conditions, and post-operative and ICU-related emergencies. Rapid detection is crucial in such cases to prevent further health deterioration into life-threatening conditions.
STAT reporting includes several imaging methods, which are listed down below:
In terms of STAT reporting, CT offers rapid results with high accuracy and quality. This method uses ionizing radiation, which is exposed onto the body from different angles. This gives several 2D images from multiple angles. A computerized system then carries out the image analysis and generates high-resolution 3D images. This technique is effective in the diagnosis of abdominal emergencies like appendicitis, bowel obstruction/perforation (99% pneumoperitoneum detection), trauma (92-98% liver/spleen injuries), and vascular issues (e.g., aneurysms via CTA).
MRI is an ideal method for analyzing soft tissue injuries or complications. MRI analyzes the water molecule movement under a magnetic field exposed to radiofrequency pulses. This creates high-resolution 3D images. It is effective in detecting acute spinal cord compression, CNS emergencies, or abdominal puzzles like indeterminate liver lesions (90-95% characterization with hepatobiliary agents), pancreatic cysts, or perianal fistulas. The scanning requires between 20 - 60 minutes. However, the method includes the use of radiation, therefore, patient health, pregnancy status, etc., need to be considered.
X-rays provide ultra-rapid detection of abnormalities, especially in the hard tissues of the body. The area of interest is exposed to ionizing radiation, which is then used to create a 2D image of the affected part. The main drawback of X-ray imaging is its poor performance in soft tissue detection. However, this method is effective in rapid visualization of fractures, heart complications, locating swallowed or embedded objects, and observing blood vessels.
The following guidelines are compiled in accordance to NCBI Bookshelf’s “Standardized Reporting,” and WHO’s “Hospital Emergency Checklist”. An ideal emergency reporting system must ensure patient safety and minimize risks through targeted measures. The key factors involved in emergency/STAT reporting are listed below:
Turnaround Time (TAT) refers to the total time taken from the moment an imaging is performed till a complete report reaches the referring clinician. TAT is one of the most crucial factors during emergency/STAT reporting, as the outcome of the case and treatment direction depend on it. In more crucial cases, a shorter TAT translates into early diagnosis and timely treatment.
Under normal circumstances, TAT can be anywhere between 1 and 24 hours. But it is important that TAT for emergencies be less than 60 minutes. TAT longer than 90 minutes increases risks and loses precious time for treatment.
Apart from this, TAT is also a crucial control point that needs to be analyzed later for improvements. After the emergency has been taken care of, the institution must consider the TAT to point out any missed opportunities or flaws in the imaging system.
