Canadian cervical spine rule: Difference between revisions
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==Rule== | ==Rule== | ||
{{Template:C-spine Canadian}} | |||
== Canadian rule vs. Nexus == | == Canadian rule vs. Nexus == | ||
Revision as of 23:12, 3 September 2015
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
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]
Canadian rule vs. Nexus
Sensitivity
Canadian 99.4% vs Nexus 90.7%
Specificity
Canadian 45.1% vs. Nexus 36.8%
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."
See Also
- EBQ:Canadian C-spine Rule Study
- C-Spine X-Ray
- NEXUS cervical spine rule
- C-Spine (EAST)
- Cervical spine clearance
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.
- N Engl J Med 2003; 349:2510-2518
- http://www.ohri.ca/emerg/cdr/cspine.html