Background:

Most patients with head injuries are managed without surgical intervention², however, as the most common cause of death and disability in individuals between 1-40 years in the UK³, prompt investigations and intervention for head injury is life-saving in traumatic cases and potentially reduces long term pressures on the health care system.

The NICE guidelines of 2003/2007 changed the primary imaging modality to assess head injury from skull radiography to CT scanning. The revised NICE guidelines, reviewed in 2023, recommend that adults with head injuries should have a CT head scan performed within 1 hour of identifying risk factors (See attached tables). It also provided a time target of one hour for a provisional radiology report to be made available to clinicians.

Audit Cycle:

CT Head requests with a history of head injury in August 2024.

Standard/Targets:

• 100% of patients should be scanned within 1 hour of risk factors being identified.
• 100% of provisional radiology reports on CT heads should be completed within one hour of the scan.
• All requests from the emergency department must have clear documentation of head injury risk factor(s) justifying the scan.

Indicators:

1. Time from CT Head request to scan.
2. Time from scan to delivery of final radiology report.
3. Correct indication for the scan.   

Data items collected: via CRIS and Sectra picture archiving systems (PACS)

1. The time the CT head request was vetted.
2. The time of the CT head was carried out.
3. The time the report was generated.
4. Risk factor criteria as per NICE guidelines.