NEXUS Chest CT decision instrument implementation.

Abnormal CXR is any thoracic injury (including clavicle fracture) or a widened mediastinum. Rapid deceleration mechanism is a fall from >20 feet (6.1 m) or a motor vehicle accident at >40 miles (64.4 km) per hour with sudden deceleration. Thoracic injury is defined as pneumothorax, hemothorax, aortic or great vessel injury, multiple rib fractures, ruptured diaphragm, sternal fracture, scapular fracture, thoracic spine fracture, esophageal injury, tracheal/bronchial injury, or pulmonary contusion/laceration. *These four criteria may be evaluated together as any thoracic wall, sternal, spine, or scapular tenderness. Sen, sensitivity; Spec, specificity.