NEXUS Chest CT Decision Instrument for CT Imaging

Why Use

Identifies patients that can safely be ruled out for clinically significant thoracic and intra-thoracic injuries, potentially safely reducing CT scanning by 25-37% in blunt trauma patients.

When to Use

Blunt trauma patients in whom CT chest is considered as part of the diagnostic evaluation.

Formula

Pearls / Pitfalls

The NEXUS CT Chest Decision Instrument is comprised of two parts, one that maximizes sensitivity for major injury and the other for major or minor injury. Uses findings from routine trauma exam. 100% sensitive for aortic and great vessel injury (a key component of the rule, as these are devastating injuries that must not be missed). Can be used sequentially with NEXUS Chest Decision Instrument for Blunt Chest Trauma .

Management

Should be used in conjunction with standard trauma evaluation and resuscitation.

Critical Actions

Clinical decision tools are meant to assist practitioners with making appropriate and evidence based decisions in the management of patients. The NEXUS CT Chest Decision Instrument suggests that a CT chest can be safely avoided in situations where the provider suspects thoracic injury, is considering CT imaging and answers negatively to the NEXUS CT Chest Decision Instrument. In these situations, the provider can feel confident that significant thoracic and intra-thoracic injuries are not missed.

Advice

If any criteria are positive, major or minor thoracic injury can NOT be excluded, and further workup, including but not limited to CT chest, is warranted.

More Information

If any criteria are positive, major or minor thoracic injury can NOT be excluded.