EBIC Center Survey


Please fill out the form and submit to EBIC Coordinating Center by the button at the end of this page.

Name of center

Address of center

Telephone

Fax

Email

Contact person (surname and name)

Contact person email

Contact person phone

Contact person cellphone

Date of visit

Visit performed by

 

Emergency & Transport

 

Inhabitants area served

<200.000
200.000-500.000
>500.000

Central collection of rescue calls?

yes
no

Rescue vehicles

ambulances
medical ambulances
helicopters
others

Patient management pre-hospital

intubated
ventilated
sedated
fluid infusion
cervical protection
chest tubes
arterial saturation mon.
ET CO2 mon.

Rescue personnel

untrained volunteers
trained volunteers (40-100h training)
nurses or professionals
general doctors
emergency doctors

Emergency Room capabilities

Abdominal ecography immediate
CT immediate
Bloodbank
Warm fluids
General surgeon in situ
General surgeon consulting
Neurosurgeon in situ
Neurosurgeon consulting
Anesthesiologist in situ
Anesthesiologist consulting

In case emergency surgery is necessary, how long it takes to start the OR procedure from the admission?

neurosurgery < 1h
neurosurgery 2h
neurosurgery > 2h
abdominal surgery < 1h
abdominal surgery 2h
abdominal surgery > 2h

 

Comments and notes (optional)

 

Patient management

 

Who manages the ICU?

intensivist
neurosurgeon
neuroanesthesist
other

Total available CT-scans (fill out number)

CT-scans available 24h/day (fill out number)

NMR

yes
no

DICOM files available?

yes
no

 

 

ICP/CPP

not
seldom
routine

 

PtiO2

not
seldom
routine

 

SaO2

not
seldom
routine

 

Brain temperature

not
seldom
routine

 

SJ O2

not
seldom
routine

 

Microdialysis

not
seldom
routine

 

EEG

not
seldom
routine

 

TC Doppler

not
seldom
routine

 

SGanz

not
seldom
routine

 

CBF

not
seldom
routine

 

Neurosurgical adult beds (fill out number)

Neurosurgical pediatric beds (fill out number)

ICU beds for neurosurgical patients (fill out number)

Post-ICU beds (fill out number)

 

 

ICU nurses/patients

1 nurse/1 patient
1 nurse/2 patients
1 nurse/3 patients
1 nurse/4 patients
1 nurse/>4 patients

 

ICU doctors/patients

1 doctor/1-3 patients
1 doctor/4-5 patients
1 doctor/>5 patients

 

Number of head injuries admitted per year (fill out number)

Number of head injuries admitted <6h after trauma (fill out number)

Number of ICP in head injuries admitted per year (fill out number)

 

Participation in previous head injury trial (fill out name(s) of study)

 

Notes (optional)

 

 


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