Kyriacou et al reported indications for ordering a chest X-ray in the Emergency Department for a patient with community-acquired pneumonia (CAP). The authors are from Northwestern University, Jesse Brown VA Medical Center, Hines VA Medical Center and Loyola University in Illinois.
Patient selection: community-acquired pneumonia in the Emergency Department
Indications for a chest X-ray - one or more of the following:
(1) fever (temperature > 99.9°F)
(2) tachycardia (heart rate > 108 beats per minute)
(3) hypoxia (oxygen saturation by pulse oximetry < 94%)
If none of these indications are present, then a chest X-ray need not be ordered.
Performance:
• The sensitivity was 70% and specificity 79% for distinguishing CAP from influenza-like illness.
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