in response to blunt chest trauma and CT

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CT scan of the chest has become highly sensitive for the work-up of 
blunt chest trauma, much of this work comes out of the Elvis presley 
trauma center in Nashville - (Author: Fabio) and is currently being 
adopted by ATLS

10% of plain chest x-rays will be normal and in fact have a major great 
vessel injury that will be picked up by high resolution spiral CT 90-
96% sensitive, thus:

Current recommendations in USA 1) upright CXR 2) if abnormal proceed 
with Chest CT 3) if abnormal proceed with an arteriogram

If initial CXR is normal and there is a high index of suspicion (high 
speed MVC) proceed with chest CT regardless, if normal many US trauma 
surgeons would then observe the patient and not perform any further 
work-up
 
Michael Wingate        

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