• L F M Beenen, K J Ponsen, T P Saltzherr, and M Lemmers.
• Trauma Unit, Department of Surgery, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
• Emerg Med J. 2010 Jul 1;27(7):522-5.

BackgroundSeveral 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.MethodsOne-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'.ResultsA 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.ConclusionThis study indicates that routine repeat chest x-rays can be omitted in trauma patients whose initial chest x-ray is normal.

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