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 AN X-RAY and imaging machine usually used in bone operations is now helping to save lives at Tan Tock Seng Hospital’s (TTSH) emergency department.
As many as four out of 10 patients who die of injuries bleed to death.
The X-ray machine, or C-arm, can locate the source of the bleeding so that doctors can stop it.
Previously, patients had to be opened up for this to be done, which was itself risky.
Between 2004 and 2008, the hospital, using the C-arm, saved 32 trauma patients who would otherwise have bled to death, said Dr Teo Li Tserng, a consultant in the department of general surgery.
The C-arm is widely used in orthopaedic surgery, such as keyhole surgery involving the spine.
Emergency doctors work in tandem with radiologists using the C-arm, which magnifies the image and allows doctors to easily locate the source of the bleeding.
Dr Daniel Wong, a senior consultant with the department of diagnostic radiology at TTSH, said small incisions, usually between 0.5cm and 1.5cm, are made and “a dye would be pumped through the vessel to locate the source of the bleeding”.
“A self-absorbable particle or coil between 1mm and 3mm would be pumped along with the dye and it is this coil that would embolise or block the artery to stop blood flow,” he said.
The procedure takes 20 to 30 minutes.
Dr Teo said that previously, open surgery was the only treatment option for trauma patients.
“Doctors would pack gauze in the cavity to help stop the blood flow but this was not the perfect solution.
“By opening a cavity to get to the bleeding vessel, we would have caused the pressure to fall, resulting in more bleeding,” he said.
TTSH treats up to 1,600 trauma patients each year, over a third of all cases in Singapore. Of these, between 350 and 450 are serious.
One of the 32 trauma patients who benefited from the C-arm was engineer Gimson Lim, 28.
A lorry had run over his pelvis after his motorcycle skidded along the highway three years ago while he was on his way to work.
“I was still conscious when the police and ambulance arrived,” he said.
Dr Teo said Mr Lim suffered multiple injuries, including a smashed pelvis and internal bleeding.
“Dr Wong, with the C-arm, managed to stop the bleeding in two major arteries before we could repair the damage to his pelvic region,” Dr Teo said.
Mr Lim was in hospital for three months and is now back at work.
The Singapore General Hospital also uses the C-arm to pinpoint bleeding in emergency trauma cases, said its head of diagnostic radiology, Associate Professor Tan Bien Soo.
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