Background/introduction
1. Up to early 2017,
out-of-hours CT brain study numbers in our hospital were controlled by insisting that requests for these studies must be made directly to the Consultant Radiologist on-call directly by the referring Consultant (Physician or Surgeon),
with some exceptions:
a. Patients with acute neurological presentations,
on request by the neurology team,
when our hospital was on neurology call.
Immediate interpretation was usually performed by the neurology team.
b. Patients with suspected head injury,
to exclude intracranial bleeding.
These requests were usually initiated...
Description of activity and work performed
1. 100 consecutive patients (60 males and 40 females) who had CT brain studies performed between 6 p.m.
and 8 a.m.
in MUH were identified (date range (1/10/2017 to 1/12/2017).
2. The indications for and the reports for all of these studies were reviewed by two of the three authors.
3. Any relevant follow-up brain imaging in MUH was reviewed.
4. Patients who had intravenous thrombolysis were identified (on the basis of clinical information provided,
and having had follow-up brain imaging post treatment).
Results:
1....
Conclusion and recommendations
1. 29% of the out-of-hours CT brain requests were apparently based on consideration for possible intravenous thrombolysis for stroke (numbers uncertain because of limited clinical information available).
2. 2 of these 29 patients had identifiable evidence of acute infarct on CT,
neither of whom was thrombolysed.
3. 27 of the 29 had no identifiable evidence of acute stroke on CT.
Of these,
none was thrombolysed (in the clinical information provided at the time of requesting the CT,
2 were explicitly declared as being considered for...
Personal/organisational information
Dr.
Adrian Brady1
Mr.
Diarmuid Moriarty2
Dr.
Peter MacEneaney1
1. Radiology Dept.,
Mercy University Hospital,
Cork,
Ireland.
2. School of Medicine,
University College,
Cork,
Ireland
References
1. Information for CNS stroke applicants (2012).
HSE Quality & Clinical Care Directorate,
Stroke Clinical Care Programme.
https://view.officeapps.live.com/op/view.aspx?src=http%3A%2F%2Fwww.hse.ie%2Feng%2Fstaff%2FJobs%2FJob_Search%2FNursing%2FArchive%2FNRS0590_Stroke_Programme_Candidate_Information.doc
2. National Clinical Guideline for stroke,
5th.
ed.
2016.
National Institute for Clinical Excellence (NICE) UK.
https://www.strokeaudit.org/SupportFiles/Documents/Guidelines/2016-National-Clinical-Guideline-for-Stroke-5t-(1).aspx
