Department of Emergency Medicine

UMEM Educational Pearls

Title: Determining who needs chest imaging in blunt trauma.

Category: Trauma

Posted: 12/24/2023 by Robert Flint, MD (Updated: 12/26/2024)
Click here to contact Robert Flint, MD

NEXUS criteria for blunt chest trauma patients who are over 14 years old, not intubated:

  • >60 years old

  • rapid deceleration defined as fall > 6 meters or motor vehicle crash >64 km/hour

  • chest pain

  • intoxication

  • abnormal alertness or mental status

  • distracting painful injury

  • tenderness to chest wall palpation

    If abnormal chest X-Ray proceed to chest CT.  Negative predictive value of 99.9% excluding major injury.

References

  1. https://radiopaedia.org/articles/nexus-chest-1?lang=us
  2. https://wikem.org/wiki/NEXUS_Chest_CT_Rule

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