🫁 NEXUS Chest Decision Instrument (Blunt Trauma)
UseWhen to use: blunt trauma patients (typically >14 y) when chest radiograph/CT is being considered.
StrataAny positive criterion supports imaging; all negative may allow omission.
LimitsWhen not to use: penetrating chest trauma or clear mediastinal injury… · Pitfall: missing distracting injury or subtle chest-wall tenderness. · Does not replace aortic imaging triggers when clinically indicated.
SourceRodriguez RM, et al. JAMA Surg 2013 (NEXUS Chest)
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
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Methodology · worked example, guidelines & full notes
Seven criteria, all-or-none low risk.
When to use
When to use: blunt trauma patients (typically >14 y) when chest radiograph/CT is being considered.
How it works
Low-risk iff ALL absent: age>60, rapid deceleration, chest pain, intoxication, abnormal alertness, distracting injury, chest-wall tenderness.
Key points
- Seven criteria, all-or-none low risk.
- Validated for selective imaging.
- Next: trauma primary survey; NEXUS Chest CT instrument if CT-specific pathway used.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Age > 60 years | No |
|---|---|
| Rapid deceleration (fall >20 ft / 6 m or MVC >40 mph / 64 km/h) | No |
| Chest pain | No |
| Intoxication | No |
| Abnormal alertness / mental status | No |
| Distracting painful injury | No |
| Tenderness to chest-wall palpation | No |
→NEXUS ChestLow-risk — imaging may be deferred
- Positive criteria：None
- Population：Typically blunt trauma age >14 in derivation/validation
| Age > 60 years | Yes |
|---|---|
| Rapid deceleration (fall >20 ft / 6 m or MVC >40 mph / 64 km/h) | Yes |
| Chest pain | Yes |
| Intoxication | Yes |
| Abnormal alertness / mental status | Yes |
| Distracting painful injury | Yes |
| Tenderness to chest-wall palpation | Yes |
→NEXUS ChestNot low-risk — image
- Positive criteria：7
- Population：Typically blunt trauma age >14 in derivation/validation
Verification & sources · governance
FAQ
Frequently asked questions
- Does NEXUS Chest Decision Instrument (Blunt Trauma) upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is NEXUS Chest Decision Instrument (Blunt Trauma) calculated in practice? Can you show a worked example?
- Inputs: Age > 60 years No, Rapid deceleration (fall >20 ft / 6 m or MVC >40 mph / 64 km/h) No, Chest pain No, Intoxication No, Abnormal alertness / mental status No, Distracting painful injury No, Tenderness to chest-wall palpation No → Result: NEXUS Chest Low-risk — imaging may be deferred（Positive criteria: None, Population: Typically blunt trauma age >14 in derivation/validation） Inputs: Age > 60 years Yes, Rapid deceleration (fall >20 ft / 6 m or MVC >40 mph / 64 km/h) Yes, Chest pain Yes, Intoxication Yes, Abnormal alertness / mental status Yes, Distracting painful injury Yes, Tenderness to chest-wall palpation Yes → Result: NEXUS Chest Not low-risk — image（Positive criteria: 7, Population: Typically blunt trauma age >14 in derivation/validation）