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Update in Radiology
Role of diagnostic imaging technologists during the COVID-19 pandemic: The importance of organization and planning in the first line
Papel del personal técnico superior en imagen para el diagnóstico durante la pandemia COVID-19: importancia de la organización y planificación en la primera línea
D. Ribas
Corresponding author
diribas@tauli.cat

Corresponding author.
, J. del Riego, J. Perendreu
Servicio de Radiología, UDIAT Centre Diagnòstic, Hospital Universitari Parc Taulí. Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Radiology plays a prominent role in the multidisciplinary management of COVID-19&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Although reverse transcription-polymerase chain reaction &#40;RT-PCR&#41; in nasal and pharyngeal secretion samples is considered the test of choice for diagnosis&#44;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> radiological tests&#44; especially chest X-ray and computed tomography &#40;CT&#41;&#44; are vitally important tools for the diagnosis&#44; prognosis and monitoring of patients with COVID-19&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#8211;5</span></a> This demonstrates the validity and enormous usefulness of these techniques in the face of new diagnostic challenges&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The rapid spread of the pandemic&#44; combined with a lack of foresight on the part of government authorities&#44; resulted in a health crisis scenario&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> The collateral effects of the pandemic must also be taken into account&#46; The increase in deaths secondary to preventable and treatable diseases is among them&#46; The rapid increase in demand has overloaded the healthcare system&#44; leaving gaps in other important areas&#46; It is vital to maintain essential services so as not to deepen the damage to society&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Like the rest of the health system&#44; radiology departments had to adapt to the pandemic<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#44; which required hasty decision-making &#40;often improvised&#41; and the preparation of dynamic contingency plans&#46; In this exceptional situation&#44; exceptional measures had to be taken and implemented quickly&#44; in order to cope with the substantial demand generated by COVID-19&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Within radiology departments&#44; the fight against COVID-19 was primarily fought on the front lines&#44; with senior diagnostic imaging technicians &#40;SDITs&#41; acting as the main agents on the battlefront&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> They certainly rose to the occasion&#44; thanks to their professionalism&#44; determination and commitment&#46; Organising SDIT staff was &#40;and still is&#41; a challenge during the pandemic&#46; The imperative to meet new healthcare demands without neglecting essential basic radiological care forced us to push our team to its limits&#44; with a fundamental reliance on strict personal care and efficient teamwork&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Our centre is a university hospital&#44; with a capacity of 697 beds&#44; and covers a demographic area of 493&#44;382 inhabitants &#40;2019&#41;&#46; The Diagnostic Imaging Department is made up of 42 adjunct specialists and 12 resident physicians in training&#44; organised by subspecialisation&#44; and has 86 SDITs&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The objective of this article is to describe&#44; detail and illustrate the different changes and decision-making processes carried out among the SDIT staff of the Diagnostic Imaging Department at our institution due to the COVID-19 pandemic&#44; as an example of organisation and coordination in a health crisis situation&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Decision-making processes and management of SDIT staff</span><p id="par0035" class="elsevierStylePara elsevierViewall">To cope with the difficulties caused by the pandemic&#44; an Executive Crisis Committee was formed with the backing of the Hospital Executive Directorate&#46; The committee was made up of&#58; the Medical Directorate&#44; the Research and Innovation Directorate&#44; the Nursing Directorate and the Human Resources Directorate&#46; It reported on decision-making to the Finance and Services Directorate&#46; Within the Diagnostic Imaging Department&#44; decision-making was a joint effort between the Department Directorate and the University Diploma in Nursing &#40;UDN&#41;&#47;SDIT Staff Management and Administration Directorate&#44; who reported weekly to the Executive Crisis Committee and conveyed the directives to the heads of the different radiology service areas &#40;abdominal&#44; neuroradiology&#44; breast and gynaecologic&#44; musculoskeletal&#44; paediatric&#44; thoracic&#44; and vascular and interventional&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">During the pandemic&#44; staff were divided into two groups of 43 people&#44; group A and group B&#46; These groups carried out their work on-site on an every-other-week basis&#46; Each group was divided into two teams&#58; &#8220;COVID-19&#8221; &#40;70&#37;&#41; and &#8220;Non&#8722;COVID-19&#8221; &#40;30&#37;&#41;&#44; depending on the work sector to which the staff were assigned&#46; In order to form these teams&#44; the Occupational Health Department was contacted&#44; and they&#44; along with the UDN&#47;SDIT Staff Management and Administration Directorate&#44; segregated staff based on various risk factors&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> SDITs with potential risk factors for severe COVID-19 due to underlying diseases &#40;e&#46;g&#46; chronic lung diseases&#44; obesity&#44; diabetes or cardiovascular disease&#41; were assigned to performing tests in patients not suspected of having COVID-19 &#40;&#8220;Non&#8722;COVID-19&#8221; team&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Due to the marked increase in demand for certain tests &#40;e&#46;g&#46; chest X-rays&#41; in the emergency setting&#44; these areas had to be bolstered&#46; To this end&#44; SDIT staff from other specific radiological areas&#44; which were closed or engaged in limited care provision&#44; were made available&#46; Before being placed in their target areas&#44; staff went through a brief period of basic training in that area and did a refresher course on safety measures in relation to personal protective equipment &#40;PPE&#41;&#46; In this way&#44; the different shifts were always made up of a professional with more experience &#40;having worked in that area for a longer period of time&#41; and a professional with less experience redirected from another area engaged in less care activity during the pandemic &#40;e&#46;g&#46; vascular and interventional radiology&#44; breast radiology&#44; magnetic resonance imaging or ultrasound&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The areas with the highest care burden were also strengthened by relocating staff with dual SDIT and UDN qualifications&#46; Professionals who normally worked as UDNs were placed as SDITs in areas of greatest need&#46; In our case&#44; there were seven of these&#58; three UDNs from vascular and interventional radiology&#44; two from magnetic resonance imaging&#44; one from breast radiology and one from ultrasound&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Staff training and protection</span><p id="par0055" class="elsevierStylePara elsevierViewall">At the beginning of the pandemic&#44; Europe reported high numbers of infections among health staff&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> This was attributed to different factors&#46; Among them&#44; the global problem of a shortage of protective equipment and a lack of awareness of transmission by asymptomatic cases in the initial phases of the pandemic might have led to infections in health staff who were not properly protected&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> In mid-May&#44; in Spain&#44; this percentage was as high as 24&#46;1&#37; of all infections in the general population&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Among the functions of the Executive Crisis Committee&#44; in line with the guidelines and protocols established by the health authorities&#44; informing and training health staff were priorities&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13&#44;14</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Bearing in mind that health workers are considered an at-risk population<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a>&#44; multiple information sessions were held for all staff &#40;both in clinical care and in auxiliary fields&#41; in which details about the virus SARS-CoV-2 and the disease COVID-19 were explained&#44; emphasising routes of transmission and precautions to be taken by health staff&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">In the Diagnostic Imaging Department&#44; protective protocols were implemented with the adaptation and provision of PPE &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; These protocols were conveyed to and duly followed by staff members&#46; In this way&#44; standardisation of care practices among SDIT staff&#44; regardless of their position or work shift&#44; was achieved&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> lists the PPE used by each healthcare circuit&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Spatial and temporal social distancing measures were also created to prevent staff contact&#44; mainly during shift changes&#46; Communication between the different work teams was carried out via institutional email&#46; The rate of infections among SDIT staff in our department was 1&#46;16&#37; &#40;1&#47;86&#41;&#59; this rate was considerably lower than that presented by the UDN and nursing assistant staff of the Emergency Department &#40;27&#46;6&#37;&#59; 31&#47;112&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Healthcare action circuits</span><p id="par0080" class="elsevierStylePara elsevierViewall">At the height of healthcare activity during the pandemic&#44; our hospital reached an overall capacity of 954 beds&#58; 578 COVID-19 &#40;60&#46;5&#37;&#41; and 376 non&#8722;COVID-19 &#40;39&#46;5&#37;&#41;&#46; The intensive care unit &#40;ICU&#41; had 76 beds &#40;65 COVID-19&#59; 11 non&#8722;COVID-19&#41; and 14 additional COVID-19 beds in the semi-critical area for patients with non-invasive ventilation&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">As a result of the increase in specific demand and the resulting forced redistribution of the healthcare burden within the radiodiagnosis department&#44; a reorganisation of technical resources and staff was needed&#46; The prominent role of radiological tests in the diagnosis and follow-up of pneumonia<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#8211;5</span></a> required a change in structure and work dynamics in which support for the Emergency Department&#44; ICU and different wards admitting COVID-19 patients was prioritised&#46; This led to the cancellation of tests considered non-essential in times of crisis &#40;such as population-based breast cancer screening&#41;&#46; In addition&#44; some diagnostic tests were performed less due to a decrease in certain pathologies during the pandemic &#40;e&#46;g&#46; reduction in polytrauma due to the lockdown&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">In line with other specialisations&#44; our organisation and work dynamics were as follows&#58; two sectors for radiological care activity were established&#46; One was the &#8220;COVID-19&#8221; sector&#44; where patients with a diagnosis confirmed by positive RT-PCR results&#44; or with clinically suspected infection&#44; received care&#46; The other was the &#8220;Non&#8722;COVID-19&#8221; sector for patients without clinically suspected infection&#46; The different imaging techniques were divided between these two sectors&#46; COVID-19 activity was prioritised and all other essential healthcare activity was maintained&#46; Both sectors had their own digital X-ray system&#44; portable conventional X-ray system&#44; CT scanner&#44; magnetic resonance imaging system and C-arm for interventional vascular radiology&#46; Due to low demand and our department&#39;s logistics&#44; a decision was made to share the emergency ultrasound system and C-arc with the interventional cardiology department&#46; This means that these two radiology techniques were used interchangeably by the two sectors&#44; with adherence to a protocol for work room disinfection&#46; Waiting rooms were closed at the height of the pandemic&#44; but were subsequently partially reopened &#40;with restricted capacity&#41;&#46; As regards recovery rooms&#44; these remained closed throughout the state of alarm&#46; <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> shows a diagram of the technology and staff used during the COVID-19 pandemic&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">Analysis of the number of emergency examinations performed between March and April 2020 compared to the same period in 2019 reveals that there was an 88&#46;9&#37; increase in the activity of the Thoracic Radiology Area&#44; secondary to a marked increase in X-rays and CT scans of the chest&#44; though the total number of emergency radiological examinations decreased by 43&#46;3&#37;&#46; Emergency radiological activity details are shown in <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">In addition to performing diagnostic tests&#44; SDIT staff played a leading role in the COVID-19 diagnosis circuit&#46; With the implementation of teleworking as the main way of working&#44; a protocol for action was established in which&#44; in the event of a radiological finding raising suspicion of COVID-19 in a planned outpatient CT scan of the chest or abdomen &#40;asymptomatic patients&#41;&#44; the SDIT had to inform the radiologist responsible for the study by telephone to initiate the rapid COVID-19 diagnosis circuit through the Emergency Department&#46; The SDIT also sent an e-mail to the UDN&#47;SDIT Staff Management and Administration Directorate&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Shortcomings and obstacles</span><p id="par0105" class="elsevierStylePara elsevierViewall">We must not limit ourselves to describing only the strong points of the organisation of SDIT staff in times of crisis&#46; It is also important&#44; and indeed our duty&#44; to describe the obstacles&#44; errors and shortcomings that we faced during the pandemic&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Undoubtedly&#44; a lack of experience with similar situations was&#44; to our understanding&#44; the most significant shortcoming&#46; This generated a constant need to adapt to the different situations that arose day after day&#46; Nobody was prepared to face such a situation&#44; and the containment plans needed to cope with this new reality were not in place&#46; The continuous improvisation led to a stressful work environment that affected all staff at all levels&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">The sharp cuts made to the Spanish health budget as a result of the 2010&#8211;2012 economic crisis<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> resulted in significantly outdated technology and a substantial lack of maintenance across all diagnostic imaging departments in Spain&#44; representing another obstacle to be overcome&#46; We were forced to cope with a significant increase in demand with old&#44; frankly obsolete&#44; equipment&#46; Predictably&#44; some equipment broke down&#46; In our case&#44; two portable conventional X-ray systems failed&#44; representing a blow to our productivity at the time of greatest need&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">The shortage of PPE was another shortcoming in the early stages of the pandemic&#46; As a result&#44; in some cases&#44; we had to prolong PPE usage times or reuse certain materials &#40;following sterilisation&#41;&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Among the public health measures put in place by governments during the COVID-19 pandemic&#44; confinement proved to be the most important&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> Confinement saves lives&#46; Of this there is no doubt&#46; However&#44; this unprecedented measure is not without consequences&#46; On the contrary&#44; many changes and new needs have surfaced in this scenario&#46; In our department&#44; it caused an increase in occupational leave related to lack of availability due to having to care for a child&#46; Certain staff capable of working during the crisis were forced to take time off for such family responsibilities&#46; In our case&#44; it represented 8&#46;1&#37; &#40;7&#47;86&#41; of the total TSID staff&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">De-escalation</span><p id="par0130" class="elsevierStylePara elsevierViewall">The de-escalation process carries several different challenges&#46; The first consists of adapting to a &#34;new normal&#34;&#44; taking into account post-pandemic safety measures&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> The second consists of planning a new workflow to deal with the large numbers of pending examinations that were postponed during the pandemic&#46; Finally&#44; staff must be relocated to their usual work areas&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">As an initial measure&#44; in accordance with the protocols established by the health authorities&#44; the capacity of the hospital centre was limited&#59; companions were restricted and waiting rooms were restructured in order to maintain safe distancing&#46; Planned examinations were also spaced out across all radiology settings&#46; At the start of de-escalation&#44; a 50&#37; schedule was established&#44; with capacity gradually increased as the weeks went by&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Regarding the scheduling of pending examinations&#44; indications for performing&#44; postponing or cancelling these was reassessed jointly with other specialisations&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">What about the future&#63;</span><p id="par0145" class="elsevierStylePara elsevierViewall">Epidemiologists know that the current pandemic will not be the last and it is only a matter of time before the next one strikes&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">In order to function better in a crisis situation&#44; all members of different care groups must receive more and better information&#46; We believe it is essential to establish protocols for action in the event of a crisis and to incorporate them into each health worker&#39;s training&#46; In addition&#44; solid prevention programmes must be developed in the face of new crises and frameworks must be created to facilitate decision-making&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">This pandemic has taught us that healthcare cuts are dangerous&#44; and that equipping healthcare centres with the necessary staff and implementing suitable technological upgrades are matters of the utmost importance&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">With regard to work dynamics&#44; we are convinced that teleradiology will become even more widely used&#46; With this in mind&#44; new tools&#44; skills and communication channels must be developed&#44; especially for purposes of proper coordination between radiologists and SDITs&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">We are aware of the limitations of this article&#46; Our study reflects only the experience of a single diagnostic imaging department and the perspective of the authors&#46; Future multicentre studies that incorporate and analyse survey data can improve understanding of how best to organise SDIT staff in the event of a pandemic&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusion</span><p id="par0170" class="elsevierStylePara elsevierViewall">Diagnostic imaging departments&#44; like all other areas of the health system&#44; were affected by and forced to adapt to the crisis caused by COVID-19&#46; We believe it is essential to recognise the role played by SDIT staff in the pandemic&#46; This group&#44; often not recognised by the system&#44; have shown their professionalism and dedication in the fight against COVID-19&#46; SDITs were one of the main frontline health workers&#44; not only enduring gruelling working hours with changing guidelines&#44; but also withstanding the stress and emotional pressure imposed by this critical situation&#46; Furthermore&#44; they had a proactive attitude as part of the rapid COVID-19 diagnosis circuit&#44; thus contributing a significant added value to their healthcare role&#46; Thanks to the measures implemented and the development of new work dynamics&#44; we were able to face the obstacles and shortcomings presented by the system&#46; Now&#44; the most important task is to learn from this experience and prepare for the future&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Authorship</span><p id="par0175" class="elsevierStylePara elsevierViewall">Responsible for the integrity of the study&#58; DR&#44; JD&#44; JP&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Study conception&#58; DR&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Study design&#58; JD&#44; DR&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Data acquisition&#58; DR&#44; JD&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Data analysis and interpretation&#58; DR&#44; JD&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Statistical processing&#58; N&#47;A&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">Literature search&#58; DR&#44; JD&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">Drafting of the manuscript&#58; JD&#44; DR&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">Critical review of the manuscript with intellectually significant contributions&#58; DR&#44; JD&#44; JP&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">Approval of the final version&#58; DR&#44; JD&#44; JP&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Conflicts of interest</span><p id="par0225" class="elsevierStylePara elsevierViewall">The sponsor and first author&#44; as well as all other contributing authors&#44; declare that there was no economic funding or any conflict of interest in the conduct of this study&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The COVID-19 pandemic and the consequent declaration of a state of alarm have required changes throughout the entire health system and diagnostic imaging departments are no exception&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">In our department&#44; these circumstances led to an immediate restructuring of the working dynamics of our group of imaging technologists that had an important role in the front lines of the battle&#46; To ensure that these new needs were met&#44; the staff had to be trained and distributed into different areas and working groups&#59; moreover&#44; new protective measures and protocols had to be adopted in the working environment&#46; We also defined different care circuits for patients with COVID-19 and those without COVID-19&#44; incorporating new technologies&#44; adapting existing resources to the new scenario&#44; and creating a circuit for the rapid diagnosis of COVID-19&#46; This paper also provides detailed recommendations for organizing radiology departments in the case of new outbreaks of COVID-19&#46;</p></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La pandemia de COVID-19 y la consecuente declaraci&#243;n del estado de alarma crearon una obligada modificaci&#243;n dentro del &#225;mbito de la sanidad en su totalidad y los servicios de radiodiagn&#243;stico no quedaron exentos&#46;</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">En nuestro servicio conllev&#243; una reestructuraci&#243;n inmediata de la din&#225;mica de trabajo del colectivo de t&#233;cnicos superiores en imagen para el diagn&#243;stico &#40;TSID&#41;&#44; que tuvo un papel destacado en la primera l&#237;nea de batalla&#46; Para lograr satisfacer las nuevas necesidades&#44; se tuvo que formar al personal&#44; distribuirlo en diferentes &#225;reas y grupos de trabajo y adoptar nuevas medidas de protecci&#243;n y cuidado en el &#225;mbito laboral&#46; Tambi&#233;n se adecuaron los diferentes circuitos de atenci&#243;n asistencial &#40;COVID-19 vs&#46; NO COVID-19&#41;&#44; incorporando tecnolog&#237;a&#44; adaptando los recursos existentes al nuevo escenario y creando un circuito r&#225;pido de diagn&#243;stico COVID-19&#46; As&#237; mismo&#44; se detallan las recomendaciones que se han de tener en cuenta sobre la estrategia organizativa dentro del servicio de radiolog&#237;a ante un posible rebrote de la pandemia&#46;</p></span>"
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          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Emergency radiology activity&#46; Bar graphs show the emergency activity during the months of March and April 2020 compared to the same period in 2019&#58; A&#41; Emergency activity of the Thoracic Radiology Area&#58; B&#41; All emergency radiology activity&#46;</p>"
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                  \t\t\t\t">Double gloves&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
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                      "titulo" => "The role of chest cmaging in catient canagement during the COVID-19 pandemic&#58; a multinational consensus statement from the Fleischner Society"
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Article information
ISSN: 21735107
Original language: English
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es en pt

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