EBQ:Canadian C-spine Rule Study: Difference between revisions
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==Study Design== | ==Study Design== | ||
Prospective cohort study of blunt trauma patients | Prospective cohort study of blunt trauma patients from 10 Canadian EDs (community and university hospitals), where each pt was evaluated for 20 standardized clinical findings before radiographs. Subset of patients were assessed by second EM physician independently. Additional 5 demographic variables obtained by study RNs from hospital records. | ||
==Inclusion Criteria== | ==Inclusion Criteria== |
Revision as of 07:23, 13 January 2014
incomplete Journal Club Article
Stiell, Ian et al. "The Canadian C-spine Rule for Radiography in Alert and Stable Trauma Patients". JAMA. 2001. 286(15):1841-1848.
PubMed Full text PDF
PubMed Full text PDF
Clinical Question
Can a clinical decision rule be used to evaluate the cervical spine in alert and stable trauma patients?
Conclusion
The Canadian C-spine rule is a highly sensitive decision rule for evaluate of clinically significant cervical spine injuries in trauma patients.
Major Points
Three Main Questions:
- Is there any high-risk factor that mandates radiography?
- Is there any low-risk factor that allows safe assessment of ROM?
- Is pt able to actively rotate neck 45° to the left and right?
Study Design
Prospective cohort study of blunt trauma patients from 10 Canadian EDs (community and university hospitals), where each pt was evaluated for 20 standardized clinical findings before radiographs. Subset of patients were assessed by second EM physician independently. Additional 5 demographic variables obtained by study RNs from hospital records.
Inclusion Criteria
- Patients sustaining acute blunt trauma to head/neck, who were at risk for C-spine injury, which is defined as the following:
- Neck pain based on mechanism of injury
- No neck pain w/ some visible injury above clavicles, non-ambulatory before, and sustained dangerous mechanism
- Patient had to be alert (GCS 15) and stable (nl VS = SBP>90 and RR 10-24/min)
Exclusion Criteria
- Age <16 years old
- Minor injuries (ie simple laceration) and did not meet inclusion criteria
- GCS<15
- Grossly abnl VS
- Injured >48hrs previously
- Penetrating trauma
- Acute paralysis
- Known vertebral disease (ie RA, spine stenosis, previous C-spine injury, anklyosing spondylitis)
- Returned for reassessment of same injury
- Pregnant
Interventions
Outcome
Primary Outcomes
Secondary Outcomes
Subgroup analysis
Criticisms & Further Discussion
Funding
CME