5. STANDARD: X-RAYS FOR EMERGENCY DEPARTMENT PATIENTS
A. Clinical studies and medical literature reveal x-rays are not immediately required on patients presenting with some acute injuries or illness. The following x-rays are not routinely indicated in patients with a reliable history and physical exam.
(1) In acute trauma
a. Nasal bones
b. Rib series
c. Skull
d. Coccyx
(2) Sinuses in acute infection
(3) Lumbar Spine for bending or lifting injuries.
B. Discharge Instructions: When the emergency medical provider determines that a patient may be discharged, written instructions should be documented on the emergency department medical record and signed by the patient. The instructions should include all of the following, as appropriate:
(1) Specific advice regarding recommended treatment and/or medications relating to the patient's clinical problem;
(2) Information about follow-up, if needed, which includes the name of an appropriate physician and/or clinic and a suggested time period in which the patient should be seen;
(3) Instructions to call or return to the Emergency Department if symptoms progress/persist or if the patient encounters difficulty in implementing the suggested follow-up plans.
