Acute Management of Renal Colic and Compliance with National Standards: Closure of the Audit Loop

Ureteric colic is a very common problem. Patients often present to A+E in significant pain, with sepsis. There are very strict guidelines produced by the BAUS and the College of Emergency Medicine. Despite this, over a quarter of UK A&E departments did not perform any radiological investigations when patients presented with renal colic. Shockingly some departments do not even offer renal colic patients any analgesia. Aims and objectives: We aim to re-audit management of patients admitted to Worcestershire Acute Hospitals with renal colic in line with BAUS guidelines (2008) over a one year period and develop recommendations in order to develop the service further. Methods: Over one year, we conducted a retrospective analysis of patient notes admitted with renal colic to Worcestershire Acute Hospitals with a focus on pain management and investigations conducted. Results: We have demonstrated that in the majority of guidelines present, our practice has improve. The majority of patients are currently having their pain re-assessed within one hour after receiving analgesia and are receiving the appropriate analgesic. However whilst 79% of those having X-ray KUB as the primary radiological investigation the same day, only 50% of those having CT are having it done the same day. Conclusions: We have demonstrated we are following guidelines in the majority of patients, however can still improve service running with further recommendations. Once clinical changes are in place, we can then re-audit the system again to see if any further change has been caused.