To analyse the demographics, clinical presentations and indications for patients receiving Head CTs after-hoursin a tertiary hospital (The Queen Elizabeth Hospital, Adelaide, South Australia) over a two month period. To determine the incidence of different intracranial pathologies within these groups. To assess the appropriateness of referrals for Head-CTs using the Canadian CT Head rule (CCHR) in traumatic head injuries. To also determine the patient outcomes from the emergency department and establishthe diagnostic yield of The Queen Elizabeth Hospital Emergency Department.

Retrospective audit of the number of Head CTs performed after hours from the Queen Elizabeth Hospital, Adelaide, South Australia. After-hours defined as Weekdays 6pm – 8am and Weekends (Friday 6pm till Monday 8am). 168 After Hours CTs were analysed over a 2 month period from 1/9/2017 to 1/11/2017. Patients were split into traumatic and non traumatic presentations. Using EPAS (Electronic Patient Records System) audit information was obtained through reading triage, admission and progress notes and RIS requests. To determine: Acute pathology General demographics Type of...

71 patients were female (42%), 98 were male (58%). Age range was 15 to 97, average age was 71. 89 CT Heads were ordered for traumatic head injuries (53%) and 80 for non-traumatic indications (47%). Refer to Table 1 for the distribution of different clinical indications for CT heads after-hours. 43 (26%) patients did not have a neurological exam performed or recorded. Of the 126 patients who had neurological examinations, 21 had focal neurological deficits and 5 of these had acute pathology - Refer to...

Outcome from ED: Outcome from ED was determined from EPAS notes. This was used to determine whether the scan had an impact on clinical decision making. Given that radiographers, nursing staff and a radiology registrar were called into the hospital after-hours, it is important to determine the necessity of these Head CTs.This is where clinical deicision rules such as the Canadian Head CT Rulecan help risk stratify patients. Canadian Head CT Rule: One of the indications for Head CTs was when the examining clinical felt...

Dr. Amaran Parasuramar MBBS Radiology Registrar SA Medical Imaging The Queen Elizabeth Hospital

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