A patient’s neck can be clinically cleared safely without radiographic imaging if all five low-risk conditions are met:
* Defined as “a condition thought by the clinician to be producing pain sufficient to distract the patients from a second (neck) injury. Examples may include, but are not limited to the following:
Physicians may also classify any injury as distracting if it is thought to have the potential to impair the patient’s ability to appreciate other injuries.
Often physicians go straight to CT imaging of the c-spine for patients with neck tenderness and moderate/high-risk findings.
NEXUS and Canadian C-spine Rules (CCR)
Hoffman JR, et al. NEJM 2000; 343: 94-9;
Stiell IG et al. JAMA. 2001 Oct 17;286(15):1841-8.
Ability to detect clinically significant c-spine injury:
NEXUS study 99.6% 12.6%
CCR Study 99.4% 45.1%