Canadian cervical spine rule: Difference between revisions

Latest revision as of 14:16, 1 May 2017

Background

Only applies to GCS=15 and stable blunt neck trauma
Not applicable for:
- Non-trauma, GCS <15, Hemodynamically unstable, Age <16, Acute paralysis, previous spinal disease or surgery

Rule

Canadian Cervical Spine Rule

Algorithm for evaluation of cervical spine injuries (Canadian C-spine Rule)

No High Risk Factors

Age >65
Dangerous mechanism (fall>3ft/5 stairs, high speed MVC (>60mph)/rollover/ejection, bicycle crash, RV, axial load injury)
Parasthesias in extremities

ANY Low Risk Factor

Simple rear end MVC
Delayed onset of pain
Sitting position in ED
Ambulatory at any time
Absence of midline C-spine tenderness

ROM

Rotates neck 45 degrees to left and right

C-spine can be cleared clinically if above criteria met^[1] ^[2]

Mnemonic

High Risk Rhyme

Sixty five,
Fast drive,
Sense deprive
(Image if alive)

Low Risk Rhyme

Slow wreck,
Slow neck,
Sitting down,
Walking around,
C-spine fine
(Range the spine)

External Links

References

↑ Stiell IG,et al. The Canadian C-spine rule for radiography in alert and stable trauma patients. JAMA. 2001 Oct 17;286(15):1841-8. EBQ:Canadian C-spine Rule Study
↑ Stiell IG, et al. The Canadian C-spine rule versus the NEXUS low-risk criteria in patients with trauma. N Engl J Med. 2003;349(26):2510-8.

Authors:

[1] Stiell IG,et al. The Canadian C-spine rule for radiography in alert and stable trauma patients. JAMA. 2001 Oct 17;286(15):1841-8. EBQ:Canadian C-spine Rule Study

[2] Stiell IG, et al. The Canadian C-spine rule versus the NEXUS low-risk criteria in patients with trauma. N Engl J Med. 2003;349(26):2510-8.

[1]

[2]

@@ Line 1: / Line 1: @@
 ==Background==
-Only applies to GCS=15 and stable [[blunt neck trauma]]. Not applicable for non-trauma, GCS&lt;15, Hemodynamically unstable, Age &lt;16, Acute paralysis, previous spinal disease or surgery.
+*Only applies to [[Glasgow Coma Scale (GCS)|GCS]]=15 and stable [[blunt neck trauma]]
+*Not applicable for:
+**Non-trauma, GCS <15, Hemodynamically unstable, Age <16, Acute paralysis, previous spinal disease or surgery
 ==Rule==
 {{Template:C-spine Canadian}}
-== Canadian rule vs. Nexus  ==
+==Mnemonic==
-=== Sensitivity  ===
+'''High Risk Rhyme'''
-Canadian 99.4% vs Nexus 90.7%
+*Sixty five,
+*Fast drive,
+*Sense deprive
+*(Image if alive)
-=== Specificity  ===
+'''Low Risk Rhyme'''
-Canadian 45.1% vs. Nexus 36.8%
+*Slow wreck,
+*Slow neck,
-Based on a prospective cohort trial Canadian rule "would have missed 1 patient and the [Nexus rule] would have missed 16 patients with important injuries."
+*Sitting down,
+*Walking around,
+*C-spine fine
+*(Range the spine)
 ==See Also==
 *[[EBQ:Canadian C-spine Rule Study]]
+*[[NEXUS cervical spine rule]]
+*[[EBQ:NEXUS]]
+*[[Blunt neck trauma]]
+*[[Cervical spine clearance]]
 *[[C-Spine X-Ray]]
-*[[NEXUS cervical spine rule]]
-*[[C-Spine (EAST)]]
+==External Links==
-* [[Cervical spine clearance]]
+*[http://www.mdcalc.com/canadian-c-spine-rule/ MDCalc Canadian C-Spine Rule]
+*[http://www.mdcalc.com/nexus-criteria-for-c-spine-imaging/ MDCalc NEXUS]
 ==References==
 <References/>
-*N Engl J Med 2003; 349:2510-2518
-*http://www.ohri.ca/emerg/cdr/cspine.html
 [[Category:Trauma]]
-[[Category:Neuro]]
+[[Category:Neurology]]
-[[Category:Ortho]]
+[[Category:Orthopedics]]
-[[Category:Rads]]
+[[Category:Radiology]]