NEXUS cervical spine rule: Difference between revisions
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**Small studies show elderly pts with c-spine fractures do not often have midline tenderness
**Small studies show elderly pts with c-spine fractures do not often have midline tenderness


==Rule==
==Workup==
Radiography is Unnecessary if pts satisfy ALL of the following low risk criteria:
{{C-spine NEXUS}}
#No midline cervical tenderness
#No focal neuro deficits
#Normal alertness
#No intoxication
#No painful distracting injury


Mneumonic - ''NSAID'':
Mneumonic - ''NSAID'':

Revision as of 08:15, 27 January 2015

Background

  • Inclusion criteria is blunt trauma to the cervical spine
  • 99.6% sensitive for a clinically important injury (only 12.9% Sp)
  • Only 8.6% of patients were elderly in the initial study; use caution in applying to elderly
    • Nexus does not risk stratify based on age like CCR
    • Small studies show elderly pts with c-spine fractures do not often have midline tenderness

Workup

NEXUS Cervical Spine Rule

Radiography is not necessary if the patient satisfies ALL of the following low risk criteria:

  • No midline cervical tenderness
  • No focal neuro deficits
  • Normal alertness
  • No intoxication
  • No painful distracting injury

C-spine imaging should be considered unless the patient meets all of the above low risk criteria[1] [2]

Mneumonic - NSAID:

  1. Neuro deficit
  2. Spinal midline tenderness in C-spine
  3. Alertness
  4. Intoxication
  5. Distracting injury

See Also

Source

Cervical Spine Injury, EB Medicine April, 2009

  1. ↑ 27. Hoffman JR, et al. Low-risk criteria for cervical-spine radiography in blunt trauma: a prospective study. Ann Emerg Med 1992;21:1454-60.
  2. ↑ Mahadevan, et al. Interrater reliability of cervical spine injury criteria inpatients with blunt trauma. Ann Emerg Med1998;31:197-201
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