How do you rule out C spine?

According to the NEXUScriteria, a patient undergoing trauma who meets all of the following criteria can have their c spine cleared clinically without imaging: No midline tenderness. No pain with neck movement. No distracting injury.

What would you use the Nexus guidelines for?

NEXUS (National Emergency X-Radiography Utilisation Study) is a set of validated criteria used to decide which trauma patients do not require cervical spine imaging. Trauma patients who do not require cervical spine imaging require all of the following: alert and stable. no focal neurologic deficit.

What is the Canadian C Spine rule used for?

The Canadian C-Spine Rules (CCR) is an assessment tool used to rule out cervical spine injury in low-risk patients, obviating the need for radiography.

What is needed for C spine clearance?

Cervical spine clearance must be attended by senior clinical medical staff, after review and reporting of the appropriate cervical spine imaging and must clearly documented in the health care record. Documentation includes: the injury description, level of injury, management plan and spinal mobility and restrictions.

What are the C spine rules in Canada?

Canadian C-spine rules are a set of guidelines that help a clinician decide if cervical spine imaging is not appropriate for a trauma patient in the emergency department. The patient must be alert and stable.

Can you get C spine clearance with a negative CT?

C-spine Clearance with Negative CT: Are We There Yet? Written by: M. Terese Whipple, MD (NUEM PGY-3) Edited by: Quentin Reuter, MD (NUEM ‘18) Expert commentary by: Matthew Levine, MD We have excellent decision rules for clinically clearing cervical spine injury in low risk patients without imaging.

When to use the C Spine Rule ( CCR )?

Most common criticism is that the CCR is difficult to memorize due to its multiple criteria; use of a smartphone app or digital reference (like MDCalc) is recommended. The rule can be used in patients who are intoxicated; if the patients are alert and cooperative, the rule should can used regardless of blood alcohol content.

When to consider C-spine imaging for cervical clearance?

C-spine imaging should be considered unless the patient meets all of the above low risk criteria A single trial showed Canadian rule would pick up 312 or 313 clinically important cases, while NEXUS would miss 1 one in 10 cases Canadian 99.4% vs Nexus 90.7% Canadian 45.1% vs. Nexus 36.8%