NEXUS Chest Decision Instrument for Blunt Chest Trauma
Determines need for chest imaging in blunt trauma patients.
Applies to patients ≥15 years old with blunt trauma within the past 24 hours in the ED. May be used sequentially with NEXUS Chest CT Decision Instrument (see Next Steps for details).
Advice
- In patients who get chest x-ray and CT is being considered, the NEXUS creators recommend using the NEXUS Chest CT Decision Instrument.
- Adequate pain control is always important in patients with trauma.
- Consider initial evaluation with chest x-ray in stable patients with isolated chest trauma.
- CT will obviously find many more injuries than x-ray, regardless of their true clinical significance.
- CT may be more useful in patients with multiple injuries or those who are sicker.