Diagnosis of subarachnoid haemorrhage: A survey of A ustralasian emergency physicians and trainees

Objective This study aims to establish current practice among A ustralasian emergency physicians and trainees on several aspects of the investigation of suspected subarachnoid haemorrhage ( SAH ). Methods An electronic questionnaire ( S urvey M onkey TM ) was distributed to emergency physicians and trainees by email through the ACEM . Survey recipients were asked about demographics, followed by a series of questions relating to the investigation of SAH . Results There were 878 survey respondents (response rate 24%). Our data showed that 47.3% of respondents agreed or strongly agreed that a CT brain within 6 h of headache onset is sufficient to exclude a diagnosis of SAH . For a CT performed within 12 h of ictus, 14.4% were satisfied that SAH could be excluded. After a negative CT scan, for further investigation of SAH , 88% of respondents preferred lumbar puncture to CT angiography. For detection of xanthochromia in the cerebrospinal fluid, 57.7% of respondents felt that spectrophotometry ( vs visual inspection) is necessary to accurately diagnose SAH . Conclusions A range of information was collected regarding the investigation of suspected SAH . We report significant differences in the diagnostic approach of A ustralasian emergency physicians and trainees to this condition, in particular the utility of CT within 6 h for exclusion of SAH .