NEXUS II - Decision Instrument (USA)
The National Emergency X-Radiography Utilization Study (NEXUS) II study of 13,728 patients across 21 centres in the United States of America was a multi-centre, prospective, observational study with the aim of developing a decision instrument to guide the use of CT imaging in blunt head injury patients.
Mower et al published the results of this study in the article "Developing a Decision Instrument to Guide Computed Tomographic Imaging of Blunt Head Injury Patients" in the Journal of Trauma-Injury Infection & Critical Care. 59(4):954-959, October 2005 (Full text link to article for CIAP users).
The study identified eight criteria that were independently and highly associated with intracranial injuries. These include:
- evidence of significant skull fracture
- scalp haematoma
- neurologic deficit
- altered level of alertness
- abnormal behaviour
- coagulopathy
- persistent vomiting
- age 65 or more
The study showed that patients who did not have any of the above criteria were unlikely to have significant injuries revealed by CT imaging and could therefore be safely discharged following a thorough evaluation without the use of CT.
Source: Mower et al. Developing a Decision Instrument to Guide Computed Tomographic Imaging of Blunt Head Injury Patients. Journal of Trauma-Injury Infection & Critical Care. 59(4):954-959, October 2005.
Also in this section:
» NSW ITIM Trauma Guidelines» Acute Managment of Head Injury in Children within the first 24 hours (NSW Health)
» Brain Trauma Foundation Guidelines (USA)
» Canadian CT Head Rule - Decision Instrument
» EAST Head Injury Trauma Practice Guideline (USA)
» Emergency Eye Manual - An Illustrated Guide (NSW Health)
» New Zealand Guidelines Group
» NICE Guidelines (UK)
» SIGN Head Injury Clinical Guideline (Scotland)
» Sport Concussion Assessment Tool (SCAT)