380 Audit of the Management of Suspected Ureteric Colic in Barnet Hospital Emergency Department

Aim Ureteric colic is a common presentation to the Emergency Department (ED) causing significant morbidity and socio-economic burden for both the patient and healthcare provider. Prompt diagnosis and symptom control aims to improve the patient experience and facilitate treatment. Our aim was to audit management within our department based on BAUS/NICE guidelines. Method We performed a retrospective review of 100 consecutive patients presenting to our ED with suspected ureteric colic who had a CT-KUB. Data was collected based on BAUS/NICE guidelines for management of suspected ureteric colic. Results 98% of patients had a CT-KUB performed within 14 hours of arrival in the ED with average time to CT-KUB of 4hrs 50mins. 22% of patients had an obstructive ureteric stone identified. Of these, 45% had a stone <4.9mm, and 55% had a stone >5mm. 75% of patients with a stone identified were referred to the renal stone MDT and 45% had a repeat CT-KUB requested. 52% of patients received analgesia in the ED, with most patients receiving oral paracetamol with an average time to administration of any analgesia from triage of 3hrs 26mins. 51% of patients had their calcium measured and 4% urate measured. Conclusions This audit demonstrates excellence in performance in terms of diagnostic imaging for suspected ureteric colic within our department. However, we identify a need to improve appropriate analgesia administration and diagnostic work up in terms of biochemistry relevant to stone pathology through education and pathway review. A second cycle of audit is currently being completed to review these interventions.