57 The Workload Distribution and Response Times of FAST Scans in a Level 3 Hospital in Ireland

Background With the advent of time sensitive treatments like thrombolysis and thrombectomy for acute ischaemic stroke, it would be expected that stroke CT would place an increased demand on CT services out of hours. Our aim is to demonstrate the change in the workload distribution in the investigation and management of acute stroke over the last year. Methods Data was collected from the radiology systems used in our hospital (NIMIS/PACS). Firstly, CT multiphase angiograms done between 17/10/2017 and 17/10/2018 were examined, followed by all FAST-positive CT brains in the same period. Arrival times for FAST positive patients were collected from the ED Symphony system. These details were used to calculate time to CT and time to report in hours and minutes. Scans were categorised into 5-time windows, in and out of hours. The process was repeated for CT brain and all other CT scans for comparison. Results 58.14% of all FAST-positive CT scans were performed out of hours. FAST positive scans accounted for 9.49% of all out of hour CT scans, this rose to 20% when examining the out of hour scans from Monday to Friday. The most common indication for non-FAST positive CT was trauma. There was a higher likelihood of receiving a CTA during hours as opposed to out of hours, (73.33% vs 66.94%). Median time to CT in FAST positive patients: window 1 – 30mins, window 2 – 49mins, window 3 – 49mins, window 4 – 34mins, window 5 – 39mins. Conclusion Stroke CT will continue to increase the out of hours work load for CT departments across the country especially with our ageing population. It is vital that services, particularly in level 3 stroke centres, are adequately equipped in terms of staffing to meet the highest standard of care in the management of acute stroke.