NEXUS Chest CT Rule: Difference between revisions
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*The rule has two sub-rules, one for detection of major injuries, and one for detection of all injuries (major and minor injuries) in hemodynamically stable, non-intubated patients | *The rule has two sub-rules, one for detection of major injuries, and one for detection of all injuries (major and minor injuries) in hemodynamically stable, non-intubated patients | ||
{{Nexus chest CT in trauma major rule}} | |||
{{Nexus chest CT in trauma minor rule}} | |||
==CT All Injuries Rule== | ==CT All Injuries Rule== | ||
''May not need a CT if all criteria are absent'' | ''May not need a CT if all criteria are absent'' | ||
Revision as of 12:33, 11 May 2016
Background
- 8 United States level 1 trauma centers enrolled patients for derivation and validation of a decision instrument to aid in the decision to perform a chest CT in patients with blunt trauma.[1]
- The rule has two sub-rules, one for detection of major injuries, and one for detection of all injuries (major and minor injuries) in hemodynamically stable, non-intubated patients
Nexus chest CT in trauma rule (major injury)
CT if any one of the following:
- Abnormal CXR
- Distracting injury
- Tenderness of:
- Chest wall
- Sternum
- Thoracic spine
- Scapula
Sensitivity
- 99% for major injuries
- 90% for minor injuries
Nexus chest CT in trauma rule (minor injury)
CT if any one of the following:
- Abnormal CXR
- Distracting injury
- Tenderness of:
- Chest wall
- Sternum
- Thoracic spine
- Scapula
- Rapid deceleration mechanism
Sensitivity
- 99% for major injuries
- 95% for minor injuries
CT All Injuries Rule
May not need a CT if all criteria are absent
- Abnormal CXR
- Distracting injury
- Chest wall tenderness
- Sternum tenderness
- Thoracic spine tenderness
- Scapula tenderness
- Rapid deceleration mechanism
Sensitivity
CT-Major Injury Rule
- 99 sensitive for major injuries
- 90% sensitive for minor injuries
CT-All Injury Rule
- 99% sensitive for major injuries
- 95% sensitive for minor injuries.