Abstracts / Injury Extra 41 (2010) 197-220 205 done with suspected viscous perforation to exclude air under the diaphragm but this does not superceed a thorough clinical examination and should not be done routinely. A retrospective analysis for all patients admitted to the Royal Glamorgan Hospital (RGH) with acute abdominal pain was done over a period of 12 months in 2004. All adult patients undergoing chest radiography (CXR) following admission as emergencies via the general surgery department

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... with abdominal signs, were identified retrospectively. The quantity and the quality (value of this investigations) was evaluated. In this study we showed that of 515 patients presenting with abdominal pain in an acute setting 65% (334) had an erect CXR on admission. Of these 5% were clinically significant showing possible medical causes for the pain and altering management. Only 1% were surgically significant showing free gas under the diaphragm. It is arguable that 314 (94% of 334) had unnecessary CXRs which contributed no new information towards treating the patient. In fact if no old radiology records were available this could have been misleading as 53 (16% of 334) had abnormal findings of which none were new. When the Royal College of Radiologists (RCR) first published guidelines for requesting radiographs it was predicted the NHS could save £50-60 million pounds per year. Now more than ever this would be vital to sustaining our health system in these trying financial times. By implementing this simple set of guidelines and relying on our clinical findings and a simple surgical opinion we might very well be able to massively reduce the financial, radiation and time resources currently being wasted.