Abstracto

CT compliance with nice guidelines 2014 for traumatic head injury

Munim Tariq

Background: Head injury is the most common cause of death and disability in individuals between 1-40 years in the UK. Patient’s prognosis could potentially be improved with early detection. The revised 2014 NICE guidelines recommended that head injuries in adults with risk factors should have a CT head scan performed within 1 hour of the risk factors being identified and a provisional radiology report should be made available within 1 hour of the scan being performed.

Aim: Aim of this audit was to evaluate how effectively CT scans following a head injury were performed in accordance with NICE guidelines

Methods: Baseline data for 36 consecutive patients was collected retrospectively. Data gathered included CT head request time, time of scan, time of report and risk factor criteria as per NICE guidelines. Standards outlined by Royal College of Radiology: a. 100% of patients should be scanned within 1 hour of risk factors being identified b. 100% of provisional radiology reports on CT-heads should be completed within 1 hour of the scan being performed c. All requests from emergency department must have clear documentation of head injury risk factor(s) justifying scan.

Discussion: There were delays in getting scan done within 1 hour and from what was gathered, this could be attributed to competition for CT machine between patients coming in with stroke, patients on anti-coagulants, patients not meeting any of the criteria or patients who met different categories of criteria.  Most in-hours reported scans were on-time with only 4 scans out of 11 were slightly delayed just above hour mark. Remaining scans were done out of hours and peak delay was between 3:00 am to 6:00 am.