982 Timing of MRI Spine for Patients Presenting with Suspected Cauda Equina Syndrome (CES)

Abstract Introduction Cauda Equina Syndrome (CES) is a neurosurgical emergency requiring urgent intervention within 24 to 48 hours to prevent irreversible paralysis and incontinence. Recognizing the gravity of CES, The Society of British Neurosurgeons and the British Association of Spine Surgeons set care standards in 2017, emphasizing the necessity for a 24/7 MRI service in every healthcare trust. The recently released GIRFT National Suspected CES Pathway also advocates for performing an MRI scan within 4 hours of presentation. Aim This study aimed to assess adherence to the 4-hour target for MRI scans in suspected CES cases at the Royal Surrey Hospital and examine the impact of delays on hospital stay length. Method Data from a 6-month period (August 2022 to January 2023) involving 70 patients were collected using the Cerner electronic system and inpatient lists, excluding cases of outpatient MRI and urgent transfers to Saint George's Hospital. Results Results showed an average time from Emergency Department admission to scanning of 21.3 hours (range: 3.5 to 87.4 hours), with a mean wait from request to scan of 14.5 hours (range: 0.7 to 76.7 hours). Hospital stay duration averaged 4.5 days (range: 1 to 22 days). Conclusions Recommendations include empowering ED clinicians to order MRI scans, implementing an MRI Safety questionnaire on Cerner, collaborating with radiographers to meet the 4-hour target, and advocating for a 24/7 MRI service within the trust. Subsequent re-audit efforts will evaluate the impact of these recommendations and identify factors influencing the achievement or non-achievement of the 4-hour target.