Does the National Emergency X-ray Utilization Study make a difference?
OBJECTIVE
To assess whether the introduction of the National Emergency X-ray Utilization Study guidelines in a UK emergency department reduced the number of patients having cervical spine radiographs and altered the accuracy of diagnosis of cervical spine injury.


METHODS
This was a prospective, observational study. The number of patients with recent neck injury who had cervical spine radiographs taken was assessed for 3 months before and three months after the introduction of the National Emergency X-ray Utilization Study guidelines to an urban emergency department in the UK. The number of injuries missed by emergency department doctors during the two 3-month periods was also recorded.


RESULTS
Prior to using the guidelines, 252 of 715 patients (35%) were X-rayed and when using the guidelines, 268 of 706 patients (38%) were X-rayed. No significant difference was observed between the rates of X-ray in the two groups (P=0.288). No injuries were missed by emergency department doctors either before or after the introduction of the guidelines.


CONCLUSIONS
Introduction of the National Emergency X-ray Utilization Study guidelines to a UK emergency department did not reduce the number of patients having cervical spine radiographs after neck trauma and had no effect on the pick-up rate for cervical spine injuries.
Dearden
Christine
C
Accident and Emergency Department, Royal Victoria Hospital, Belfast, Northern Ireland. Christine.deaeden@royalhospitals.n-i.nhs.uk
Hughes
Declan
D
D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D017408:Guidelines as Topic; D006801:Humans; D019838:Neck Injuries / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D011859:Radiography / Q000706:statistics & numerical data*; D006113:United Kingdom