Canadian cervical spine rule: Difference between revisions

Revision as of 23:16, 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

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]

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

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 4: / Line 4: @@
 ==Rule==
 {{Template:C-spine Canadian}}
-== 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==