Current practice of routine cranial ultrasonography in level 3 units across the United Kingdom

Abstract

<h3>Aim</h3> To look at the variations in current practice of routine head scan in preterm infants in different level 3 neonatal units. <h3>Methods</h3> A telephone survey has been conducted between February-2011 and April-2011 among all level 3 NICU in UK. Information gathered on routine head scan screening as per local protocol over telephone. We used a standard format to collect information on various aspects of routine cranial ultrasound screening of preterm infants. <h3>Results</h3> We identified total of 59 level 3 units of which data obtained from 51 units (86%) across the UK. We found majority of the units (91%) have written guidelines with 74% of analysed units use 32 weeks of gestational age as their cut-off to start screening. All units perform first ever scan within the first 72 hours of life and finish at term equivalent age. A trend in involvement of local radiology service for routine head scan screening was noted (45% of total units studied). 59% of units in UK used computerised archiving system to store images. In our survey 95% of UK units have trainees undertaking and reporting some of the routine head scan images. 37% of level 3 units organised regular formal review meeting along with radiologists. Only 10% of units use a structured format for reporting images. All units in this survey have facility to organise brain MRI if requires and follow up clinic up to 2 years of age. <h3>Conclusion</h3> Widespread use current evidence based policies for routine head scan for preterm infants with some variability was noted. There is trend of using local radiology service although no previous figures available. There is definitely a need for national guideline for this screening programme with clear instruction for radiology service involvement. Although there is opportunity available for paediatric trainees to develop this important clinical skill, there is a lack of guideline on competency development from RCPCH and/or BAPM. Use of structured format to report images should be encouraged to increase uniformity and clarity. This study gave us the general insight of our current practice which now could be compared with other worldwide practices.