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Are routine repeat chest x-rays before leaving the trauma room useful?
  1. M Lemmers1,
  2. T P Saltzherr1,
  3. L F M Beenen2,
  4. K J Ponsen1,
  5. J C Goslings1
  1. 1Trauma Unit, Department of Surgery, Academic Medical Center, University of Amsterdam, The Netherlands
  2. 2Department of Radiology, Academic Medical Center, University of Amsterdam, The Netherlands
  1. Correspondence to T P Saltzherr, Academic Medical Center, Trauma Unit, Department of Surgery, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; t.p.saltzherr{at}amc.uva.nl

Abstract

Background Several guidelines advocate multiple chest x-rays during primary resuscitation of trauma patients. Some local hospital protocols include a repeat x-ray before leaving the trauma resuscitation room (TR). The purpose of this study was to determine the value of routine repeat x-rays.

Methods One-year data of all radiological imaging in the TR were prospectively collected for all patients presenting to the TR of the hospital. The x-rays were counted and assessed and the findings were classified as either ‘new injury detected’, ‘presence of intervention devices’ or ‘deterioration of previously detected injury’.

Results A total of 674 patients were included. More than 75% had two x-rays. Eight (2.1%) new injuries without clinical relevance were found on the repeat x-ray after an initial normal x-ray. 61 patients (9%) had a repeat x-ray to verify the effect of an intervention or position of devices. In 28 patients (22%) with two abnormal x-rays, newly diagnosed injuries (n=9) or deterioration of known injuries (n=19) were found. In 411 patients (81%) the results of the repeat x-ray had no clinical consequences.

Conclusion This study indicates that routine repeat chest x-rays can be omitted in trauma patients whose initial chest x-ray is normal.

  • Repeat
  • routine
  • chest x-ray
  • trauma
  • imaging
  • x-ray
  • management
  • emergency department management
  • paramedics
  • guidelines
  • chest

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Footnotes

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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