RT Journal Article
SR Electronic
T1 Are routine repeat chest x-rays before leaving the trauma room useful?
JF Emergency Medicine Journal
JO Emerg Med J
FD BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine
SP 522
OP 525
DO 10.1136/emj.2009.078519
VO 27
IS 7
A1 M Lemmers
A1 T P Saltzherr
A1 L F M Beenen
A1 K J Ponsen
A1 J C Goslings
YR 2010
UL http://emj.bmj.com/content/27/7/522.abstract
AB 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.