The NEXUS Chest Decision Instrument (NEXUS Chest X-ray) is a clinical calculator used in the evaluation of patients who have experienced blunt chest trauma. This scoring system is designed to identify patients who are at low risk of injury and therefore may not require imaging, specifically chest X-ray, thus reducing unnecessary radiation exposure and healthcare costs.

The NEXUS Chest X-ray is applicable to patients who have sustained blunt chest trauma, often due to incidents such as motor vehicle accidents, falls, or physical assaults. 

The clinical utility of this calculator is to aid in the decision-making process of whether a chest X-ray is necessary, based on the presence or absence of certain criteria. These criteria include age over 60, rapid deceleration mechanism, chest pain, intoxication, altered mental status, distracting painful injury, and tenderness in the chest wall, sternum, thoracic spine, or scapula.

Patients who do not meet any of these criteria are considered at low risk for significant injury and may not require a chest X-ray. However, the decision to forego imaging should always be made in conjunction with clinical judgment. 

The NEXUS Chest X-ray should not be used in patients with penetrating chest trauma, those with a known history of chest injury or

NEXUS criteria for chest X-ray in blunt chest trauma

# Criteria
 A. Age > 60 years (+1)
B. Rapid deceleration mechanism (fall from > 6 m or motor vehicle crash > 64 km/hour) (+1)
C. Chest pain (+1)
D. Intoxication (+1)
E. Altered mental status (+1)
F. Distracting painful injury (+1)
G. Chest wall tenderness (+1)

# Conditions
- score == 0
- score >= 1