Background and Objective:  Stroke is a health problem and major cause of disability and death worldwide. Computed tomography (CT) of the brain is importance for evaluate acute ischemic stroke patients. The aimed of this study was to develop guideline of using CT images by Alberta Stroke Program Early CT Score (ASPECTS ) in acute ischemic stroke patients in Stroke Fast Track.

Method: This research and development study was performed in Yasothon hospital. There were three phases of study.  Phase 1: Reviewed medical records and CT images of the brain in acute ischemic stroke from January-June 2018 in Stroke Fast Track of 120 patients. Phase 2: Develop guideline of using ASPECTS in patients and trial in January-March 2019 of 72 patients  by 14 interns  and 7 internists who conducted activities according to the development guideline. Phase 3: Evaluate the post test of development guideline.

Result: Reviewing of data revealed median of CT initiation and CT interpretation time was 29 minutes which longer than the goal according to the American Heart Association/ American Stroke Association (AHA/ASA) treatment guideline. Median of Door to CT interpretation time was 36 minutes. The Better ASPECTS group had severity and stroke outcome at discharge better than the Worse ASPECTS group it was statistically significant. Group of Hyperdense MCA sign had worse stroke outcome. Post test according to development guideline revealed good concordance between radiologists and interns (ICC=0.820, 95% CI=0.712-0.887). CT initiation and CT interpretation Door to CT interpretation was statistically significant lower than before development. The most opinions of interns and internist for the development were at a high level and the most.

Conclusion: Development of using ASPECTS in acute ischemic stroke patients improved examination time and interpretation of radiology .There was CT  interpretation guideline in acute ischemic stroke . The relevant personnel agreement with the development were at a high level and  the most.