Article Text

Download PDFPDF
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

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Footnotes

  • Competing interests None.

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