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S18-8
(P)
'STRAIGHT TO THE OPERATING ROOM' TRANSFER FOR TESTICULAR TORSION
DIAGNOSED AT OUTSIDE FACILITIES: BYPASS THE EMERGENCY ROOM TO SAVE
TESTES
Vani MENON
1
, Lauren OSTROV
2
, Gwen GRIMSBY
1
, Bruce SCHLOMER
1
and Linda BAKER
1
1) University of Texas - Dallas, Southwestern, Pediatric Urology, Dallas, USA - 2) Children's Health, Access Center,
Dallas, USA
PURPOSE
Testicular torsion is one of the few emergencies where delays can result in organ loss. At our institution nearly 25% of
patients are diagnosed with torsion at an outside emergency room (ER). In order to improve the quality of care, we
instituted a ‘straight to the OR’ (STOR) initiative which would bypass the ER thereby decreasing the ‘arrival to OR time’
for emergent torsion.
MATERIAL AND METHODS
Pediatric urologists activated the STOR initiative after telephone diagnosis of torsion on outside ultrasound. A
coordinated transfer brought the child from the outside ER directly to the preoperative area permitting STOR. An IRB
approved retrospective database was compiled from 1/2012 to 1/2014; records were reviewed for repeat ultrasounds,
‘arrival to OR time’, and surgically confirmed torsion.
RESULTS
There were 46 patients transferred with a torsion diagnosis, 18 of whom underwent the STOR initiative. When
compared to non-STOR patients (n = 28), STOR patients were less likely to have repeat ultrasound (0/18 vs 6/28,
p=0.07), as likely to have surgically confirmed torsion (17/18 vs 27/28, p = 0.9), and had an average ‘arrival to OR
time’ of 59 minutes versus 124 minutes for the non-STOR group (p<0.001).
CONCLUSIONS
In this experience, testicular torsion was accurately diagnosed at outside ERs. The STOR initiative maximized the
chance of testicular salvage by decreasing time until surgical intervention by over one hour. Given the significant time
savings, it is rational to propose this initiative at other referral centers.