emDocs - June 26, 2017 - Authors: Simon E and Sessions D
Edited by: Koyfman A and Singh M
"Bottom line
Both NEXUS Chest CT-All and CT-Major have > 99% sensitivity in detecting major thoracic injuries. NEXUS Chest CT-All has > 95% sensitivity in detecting major and minor thoracic injuries following blunt trauma (in patients presenting within 6 hours of injury).
If you’ve read to this point and are wondering, what about ultrasound? We’ve got you covered:
Bedside ultrasound is a useful adjunct in the evaluation of patients presenting following blunt chest injury as it allows for the rapid detection of pneumothoraces, hemothoraces, and pericardial effusions. As compared to CXR, US demonstrates greater sensitivity for the detection of pneumothoraces (sensitivity 86%30) and is more accurate in the diagnosis of hemothoraces, however, CT remains the gold standard.
To summarize our discussion:
Note: This varies from the widely accepted trauma surgery approach, which would advocate for a screening CXR in the evaluation of a patient who sustains blunt chest injury."