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


==CT Major Injury Rule==
{{Nexus chest CT in trauma major rule}}
''May not need a CT if all criteria are absent''
 
#Abnormal CXR
{{Nexus chest CT in trauma minor rule}}
#Distracting injury
#Chest wall tenderness
#Sternum tenderness
#Thoracic spine tenderness
#Scapula tenderness
==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.
==See Also==
==See Also==
*[[NEXUS cervical spine rule]]
*[[NEXUS cervical spine rule]]
*[[Thoracic trauma]]
==External Links==
==External Links==


==References==
==References==
<references/>
<references/>
[[Category:Trauma]]
[[Category:Pulmonary]]

Latest revision as of 13:00, 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

See Also

External Links

References

  1. Rodriguez, RM et al. Derivation and validation of two decision instruments for selective chest CT in blunt trauma: a multicenter prospective observational study (NEXUS Chest CT). PLoS Med. 2015 Oct 6;12(10):e1001883.full text