ASSESSING Cx SPINE CLINICALLY

CERVICAL SPINE INJURIES

CERVICAL COLLARS

Why?

Disadvantages

CLEARING THE Cx SPINE

RATIONALE

 

PROCEDURE

 

Keep the collar in place and do not examine any further if the patient has:

(Nexus criteria) 1

+/-

(Canadian Cervical spine criteria)2

 

If none of the above:

Prepare the patient by telling them:

Check for midline tenderness

Check for head control

 

SUMMARY

In order

ELSE remove collar and xrays not required

 

  1. Hoffman, J.R., et al. Validity of a set of clinical criterial to rule out injury to the cervical spine in patients with blunt trauma.  N Engl J Med 2000 July 13; 343(2):94,
  2. Bandiera, G., et al.  The Canadian C-spine rule performs better than unstructured physician judgement.  Ann Emerg Med September 2003; 42(3):395,

NB Their is inconclusive evident that the Canadian C-spine outperforms NEXUS criteria in identifying significant cervical fractures

Mower, W.R., et al. Comparison of the Canadian C-spine rule and NEXUS decision instrument in evaluating blunt trauma patients for cervical spine injury.  Ann Emerg Med April 2004; 43(4):515