Projected paediatric cervical spine imaging rates with application of NEXUS, Canadian C-Spine and PECARN clinical decision rules in a prospective Australian cohort

Comparison of the Canadian C-Spine rule and NEXUS decision instrument in evaluating blunt trauma patients for cervical spine injury.

Concerned about missing potentially catastrophic neurologic injury, emergency physicians have typically made liberal use of radiographic imaging to evaluate blunt trauma patients for cervical spine injuries. This practice subjects large numbers of patients to imaging, with its associated cost, time expenditure, and radiation exposure, in order to detect injury in a small minority. Consequently,...

The Canadian C-spine rule safely reduces imaging rates for cervical spine injuries.

Question: Does implementation of the Canadian C-spine rule in emergency departments reduce the proportion of patients referred for diagnostic imaging of the cervical spine without a concurrent increase in unidentified cervical spine injuries or serious adverse outcomes? Design: Matched pair cluster randomised trial. Setting: 12 emergency departments of teaching and community hospitals in Canada...

Canadian C-spine rules require validation and appropriate application.

The Canadian C-spine rules were published in 2001 (Stiell et. al.). Essentially, they state that the presence of any of a number of high risk factors (age greater than 65, dangerous mechanism of injury, or paraesthesia in extremities) mandates cervical spine radiology. If a defined set of low risk factors, that allow safe assessment of range of motion, are present, patients are asked to rotate ...

The Canadian C-Spine Rule more accurately identified cervical-spine injury in trauma than the NEXUS Low-Risk Criteria.

Accuracy of the Canadian C-spine rule and NEXUS to screen for clinically important cervical spine injury in patients following blunt trauma: a systematic review.

BACKGROUND There is uncertainty about the optimal approach to screen for clinically important cervical spine (C-spine) injury following blunt trauma. We conducted a systematic review to investigate the diagnostic accuracy of the Canadian C-spine rule and the National Emergency X-Radiography Utilization Study (NEXUS) criteria, 2 rules that are available to assist emergency physicians to assess t...