CT scanning in stroke patients: meeting the challenge in the remote and rural district general hospital.
BACKGROUND
National audit data allow crude comparison between centres and indicate that most Scottish hospitals fail to meet current guidelines for CT scanning of the brain in stroke patients. This study identifies some of the reasons for delay in performing CT scans in a largely rural population.


METHODS
This audit study assesses the delays from onset of symptoms, time of admission and request received to CT scan in stroke patients for three different in-patient groups as well as those managed in the community.


RESULTS
The reasons for delay in CT scanning varied between different patient groups but for one group of in-patients, changes in booking procedure and introduction of a second CT scanner increased the proportion scanned within 48 hours of request from 65% to 96%.


CONCLUSIONS
Further developments including the introduction of Saturday and Sunday routine CT scanning, radiologist reporting from home and additional CT scanners placed in remote hospitals may be expected to improve these figures further. Target times of three hours from onset of symptoms to scan to allow thrombolysis may however be impossible to meet for all stroke patients in rural areas.
Todd
A W
AW
Radiology Department, Raigmore Hospital, Inverness, UK. alistair.todd@haht.scot.nhs.uk
Anderson
E M
EM
D005500:Follow-Up Studies; D019983:Guideline Adherence; D006297:Health Services Accessibility / Q000458:organization & administration*; D006767:Hospitals, District; D006769:Hospitals, General; D006780:Hospitals, Rural; D006801:Humans; D008485:Medical Audit; D017410:Practice Guidelines as Topic; D019035:Rural Health Services / Q000458:organization & administration*; D012606:Scotland; D020521:Stroke / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*