title: Complementary exams in blunt torso trauma. Perform only radiographs and fast: is it safe?
abstract: OBJECTIVE
  to evaluate effectiveness of using chest X-ray (CXR), pelvis X-ray (RXP) and FAST (Focused Abdominal Sonography on Trauma) to exclude significant lesions of the body in blunt trauma.
  
  
  METHODS
  a prospective study involving 74 patients whom made the three tests (CXR, RXP and FAST) during the initial evaluation between October 2013 and February 2014. The results were compared to the tomography of the same patients or clinical outcome. If the patient did not have alterations on the CT scans or during the observation time, the initial workup was considered safe. All patients were evaluated at the Hospital João XXIII, Belo Horizonte, Brazil.
  
  
  RESULTS
  of the 74 patients studied the average age was 33 years, RTS: 6.98, ECG: 12. From 44 (59.45%) patients with exams (radiographs and FAST) unchanged, three had significant injuries (two splenic injuries and one liver injury) diagnosed by clinical monitoring. The remaining patients - 30 (40.55%) - had at least one alteration in conventional tests. Of these group 27 (90%) had significant injuries and three (10%) minor injuries. The sensitivity of all three tests for screening considerable lesions was 90% and the specificity was 93%. The negative predictive value was 93% and the positive predictive value 89%.
  
  
  CONCLUSIONS
  this research showed that all the three exams - chest X-ray, pelvis and FAST - are safe to lead with the blunt trauma if well used and associated with clinical examination.
authors.affiliation: Hospital João XXIII, Belo Horizonte, MG, Brasil.
authors.forename: Fábio Mendes
authors.initials: FM
authors.lastname: Botelho Filho
authors.affiliation: Hospital João XXIII, Belo Horizonte, MG, Brasil.
authors.forename: Roberto Carlos
authors.initials: RC
authors.lastname: de Oliveira e Silva
authors.affiliation: Hospital João XXIII, Belo Horizonte, MG, Brasil.
authors.forename: Sizenando Vieira
authors.initials: SV
authors.lastname: Starling
authors.affiliation: Faculdade de Medicina, Universidade Federal de Minas Gerais, MG, Brazil.
authors.forename: Diego Pereira
authors.initials: DP
authors.lastname: Zille
authors.affiliation: Hospital João XXIII, Belo Horizonte, MG, Brasil.
authors.forename: Domingos André Fernandes
authors.initials: DA
authors.lastname: Drumond
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging; D000328:Adult; D006801:Humans; D010388:Pelvis / Q000000981:diagnostic imaging; D011446:Prospective Studies; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed; D060726:Torso / Q000000981:diagnostic imaging* / Q000293:injuries*; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*