Middlemore Hospital is in desperate need of a new CT scanner. But the device comes with a $1million price-tag.

The hospital gets government money every year to meet its needs for new equipment, but other priorities meant the CT scanner was not able to be funded.

"The money only goes so far, but that doesn’t stop us wanting the best for the people of our area,” Foundation chief executive pam Tregonning said.

"It is a huge amount of money to have to raise, and we will never achieve it without the support of businesses and the community,” she said.

Mrs Tregonning appealed to employers and businesses to get behind the campaign. "We need some businesses to back their hospital, to provide a cornerstone investment that will make the project possible.”

Counties Manukau District Health Board chief executive Geraint Martin said good things were being achieved at Middlemore, but more could always be done, especially if medical staff had access to the latest technology.

The CT scanner would be in Emergency Care, a 97-bed acute care facility that has six resuscitation rooms, eight monitored rooms, 27 assessment rooms, two procedure rooms, a dedicated plastering room, an ear, nose & throat room, and a 24-bed adult short stay uni.

It also houses Kidz First Emergency Care and its two resuscitation rooms, 14 acute assessment rooms, procedure room and a 13-bed short stay area.

The Emergency Care unit is Australasia’s busiest, with nearly 100,000 patients a year, but, there is no CT scanner, a major negative in providing effective emergency care.

The scanners take cross-sectional images, and are useful in showing internal organs because the images give more detail, and aid in the diagnosis of injury and illness.

Auckland Hospital has five scanners, including one in Emergency; the Waitemata District Health Board has three.

Middlemore does have two scanners in Radiology, running 24/7 for acute patients, so many referred by Emergency Care at nights and weekends that they make up 40 per cent of all CT scanning at Middlemore.

Both are around three years old but demand continues to rise and the hospital is finding it increasingly difficult to absorb more patients. And because some procedures are lengthy, that can reduce throughput from around 20 procedures a session to three or four.

Radiology is also a long way from Emergency Care, so acute patients must be moved away from Emergency Care and the new theatres, and then back – an extra risk to patient recovery.

About 9500 patients a year go to and from Emergency to the scanners, moving in public corridors, giving reduced patient dignity.

"It is all about speed and access at a critical time. CT scanning within the unit would enhance our ability to make the right decisions from the right information provided,”

Middlemore Hospital ED clinical head Vanessa Thornton said.

"Every time those moves take place it ties up clinical staff, doctors, nurses, specialists and orderlies, a situation that’s even worse at night, when staff levels are reduced.”

She said CT scanning would reduce time delays, provide greater access, and have the flow-on benefit of increasing existing scanner capacity because patients with appointments would not be bumped by trauma cases.

Patient safety would be enhanced by having radiologists and Emergency staff together, improving consultation, reducing clinical variation and aiding diagnosis.

The board is making plans to site a scanner a short distance from the resuscitation rooms, and opposite the access lifts to the theatres, providing a natural route for patients from Emergency to CT, and then to theatre, with minimal delay. But even that will mean significant costs.

"It makes sense because we have a small but significant number of patients who miss out on a CT scan, the acute patients who go straight to theatre but should be being scanned,” CT Radiologist Elisa Perry said.

Benefits to the community would include an improved and faster CT service provided at a better location, reduced radiation doses, diagnosis improvements, reduced lengths of stay, reduced delays in trauma cases, less patient movement in corridors, and the freeing up of clinical staff.

"As the population in the Counties region increases, and we continue to strive to provide the best possible service for our people, a CT scanner in Emergency is a vital piece of radiology equipment,” Middlemore Radiology clinical head Sally Urry said.

Unfortunately many children are injured each year in playground falls, playing sport, around the house or in car crashes.

When the enter Emergency Care they cannot go directly to a CT scanner. Instead doctors frequently have to make a diagnosis without the use of the most critical piece of diagnostic equipment available to modern medicine.

Put simply, there is just not time to wheel patients down corridors for scanning, then back to Emergency Care, and from there to theatre. Minutes are critical.

Practicality means the CT stage is often omitted, leaving surgeons without the full knowledge they need.

And sometimes unusual things can be detected by CT scanning.

Last November a woman presented to Middlemore Emergency Care. It turned out she had been shot in the head. She survived – but only after a CT scan revealed the bullet - seen at right.

It had torn through her head, smashing her upper jaw and palate, and shredding soft tissue until it lodged centimetres from the back of her neck, missing all three of the main blood vessels that service the brain.

She was sent for a CT scan and it was only then that it was discovered she had been shot. The entry wound was inside the mouth, above her left front teeth.

The surgeon cleared the damaged area but stopped about 4cm back into her jaw, along the bullet's path, for fear of hitting a major blood vessel. The bullet was recovered by rolling the woman on to her side and making an incision in the back of her neck.

She was in intensive care for six days, and spent another three weeks in Middlemore. The word miracle was frequently mentioned.

To support Middlemore Hospital and the foundation’s work

• Post cheques to Middlemore Foundation, Middlemore Hospital, Floor 3, Bray Building, Hospital Rd, Otahuhu, Auckland 1640

• Make an online donation

• Direct deposit to ASB Hunter’s Corner 12 3113 0002022 00

• For queries call the Middlemore Foundation on 09 270 8808