Are routine repeat chest x-rays before leaving the trauma room useful?
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.


CONCLUSIONS
This study indicates that routine repeat chest x-rays can be omitted in trauma patients whose initial chest x-ray is normal.
Lemmers
M
M
Trauma Unit, Department of Surgery, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Saltzherr
T P
TP
Beenen
L F M
LF
Ponsen
K J
KJ
Goslings
J C
JC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011446:Prospective Studies; D013902:Radiography, Thoracic; D014193:Trauma Centers / Q000706:statistics & numerical data; D019564:Unnecessary Procedures; D014947:Wounds and Injuries / Q000000981:diagnostic imaging*