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Canadian c spine rule

Marc D Benayoun, Jason W Allen, Brendan P Lovasik, Matthew L Uriell, Robert M Spandorfer, Chad A Holder
BACKGROUND: Computed tomography (CT) of the cervical spine (C-spine) is routinely ordered for low-risk mechanisms of injury, including ground-level fall. Two commonly used clinical decision rules (CDRs) to guide C-spine imaging in trauma are the National Emergency X-Radiography Utilization Study (NEXUS) and the Canadian Cervical Spine Rule for Radiography (CCR). METHODS: Retrospective cross-sectional study of 3,753 consecutive adult patients presenting to an urban Level I emergency department who received C-spine CT scans were obtained over a 6-month period...
August 2016: Journal of Trauma and Acute Care Surgery
John Tran, Donald Jeanmonod, Darin Agresti, Khalief Hamden, Rebecca K Jeanmonod
INTRODUCTION: The National Emergency X-radiography Utilization Study (NEXUS) criteria are used extensively in emergency departments to rule out C-spine injuries (CSI) in the general population. Although the NEXUS validation set included 2,943 elderly patients, multiple case reports and the Canadian C-Spine Rules question the validity of applying NEXUS to geriatric populations. The objective of this study was to validate a modified NEXUS criteria in a low-risk elderly fall population with two changes: a modified definition for distracting injury and the definition of normal mentation...
May 2016: Western Journal of Emergency Medicine
Bruno Tirotti Saragiotto, Zoe A Michaleff
No abstract text is available yet for this article.
July 2016: Journal of Physiotherapy
Marc D Benayoun, Jason W Allen, Brendan P Lovasik, Matthew Uriell, Robert M Spandorfer, Chad A Holder
BACKGROUND: CT of the cervical spine is routinely ordered for low-risk mechanisms of injury, including ground level fall (GLF). Two commonly employed clinical decision rules (CDRs) to guide C-spine imaging in trauma are the National Emergency X-Radiography Utilization Study (NEXUS) and the Canadian Cervical Spine Rule for Radiography (CCR). METHODS: Retrospective cross-sectional study of 3,753 consecutive adult patients presenting to an urban Level I ED who received C-spine CT scans were obtained over a six month period...
March 30, 2016: Journal of Trauma and Acute Care Surgery
Tanya L Zakrison, Brian H Williams
BACKGROUND: Cervical spine injuries causing spinal cord trauma are rare in blunt trauma yet lead to devastating morbidity and mortality when they occur. There exists considerable debate in the literature about the best way for clinicians to proceed in ruling out cervical spine injuries in alert or obtunded blunt trauma patients. METHODS: We reviewed the current literature and practice management guidelines to generate clinical recommendations for the detection and clearance of cervical spine injuries in the blunt trauma patient...
January 28, 2016: International Journal of Surgery
C Schöneberg, B Schweiger, B Hussmann, M D Kauther, S Lendemans, C Waydhas
OBJECTIVE: The objective of this systematic review was to discuss current knowledge of the diagnostic management of cervical spine (c-spine) injuries in children. METHODS: Studies dealing with this topic were collected from the following sources: MEDLINE via PubMed, Embase, and Cochrane. Where possible, a meta-analysis was performed. Furthermore, the level of evidence for all the included publications was assigned. RESULTS: The incidence of cervical spine injury (CSI) in children is rare (1...
December 2013: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Catherine M Clement, Ian G Stiell, Maureen A Lowe, Jamie C Brehaut, Lisa A Calder, Christian Vaillancourt, Jeffrey J Perry
OBJECTIVES: We recently conducted a multicentre implementation study on the use of the Canadian C-Spine Rule (CCR) by emergency department (ED) nurses to clear the c-spine in alert and stable trauma patients (n = 4506). The objective of this study was to conduct a survey of nurses, physicians, and administrators to evaluate their views on the facilitators and barriers to the implementation of the CCR. METHODS: We conducted both a paper-based and an electronic survey of the three different ED hospital staff groups of nine large teaching hospitals in Ontario, including six regional trauma centres...
July 2016: International Emergency Nursing
Ulrich Linsenmaier, Zsuszsanna Deak, Aina Krtakovska, Francesco Ruschi, Nora Kammer, Stefan Wirth, Maximilian Reiser, Lucas Geyer
OBJECTIVE: To evaluate whether straightening of the cervical spine (C-spine) alignment after trauma can be considered a significant multidetector CT (MDCT) finding. METHODS: 160 consecutive patients after C-spine trauma admitted to a Level 1 trauma centre received MDCT according to Canadian Cervical Spine Rule and National Emergency X-Radiography Utilization Study indication rule; subgroups with and without cervical collar immobilization (CCI +/-) were compared with a control group (n = 20) of non-traumatized patients...
2016: British Journal of Radiology
Rajdeep Kanwar, Bronson E Delasobera, Korin Hudson, William Frohna
Most spinal cord injuries involve the cervical spine, highlighting the importance of recognition and proper management by emergency physicians. Initial cervical spine injury management should follow the ABCDE (airway, breathing, circulation, disability, exposure) procedure detailed by Advanced Trauma Life Support. NEXUS (National Emergency X-Radiography Utilization Study) criteria and Canadian C-spine Rule are clinical decision-making tools providing guidelines of when to obtain imaging. Computed tomography scans are the preferred initial imaging modality...
May 2015: Emergency Medicine Clinics of North America
Kenji Inaba, Lauren Nosanov, Jay Menaker, Patrick Bosarge, Lashonda Williams, David Turay, Riad Cachecho, Marc de Moya, Marko Bukur, Jordan Carl, Leslie Kobayashi, Stephen Kaminski, Alec Beekley, Mario Gomez, Dimitra Skiada
BACKGROUND: Unlike the cervical spine (C-spine), where National Emergency X-Radiography Utilization Study (NEXUS) and the Canadian C-spine Rules can be used, evidence-based thoracolumbar spine (TL-spine) clearance guidelines do not exist. The aim of this study was to develop a clinical decision rule for evaluating the TL-spine after injury. METHODS: Adult (≥15 years) blunt trauma patients were prospectively enrolled at 13 US trauma centers (January 2012 to January 2014)...
March 2015: Journal of Trauma and Acute Care Surgery
Maria Bohr Dawids, Marie Lillevang-Johansen
A 77-year-old woman had a total luxation of C5-C6 after falling 1 m down a staircase. She presented with atypical symptoms, i.e. shoulder- and back pain, and later pareses of the left arm. The initial clinical findings did not warrant radiography, which delayed the correct diagnosis of her serious condition. When diagnosed she received surgical stabilization of her fractures. We recommend the use of a validated set of rules for radiography, e.g. Canadian C-spine Rule or National Emergency X-radiography Utilization Study low-risk criteria on all elderly patients admitted after fall-trauma to rule out cervical injury even with no typical symptoms...
May 12, 2014: Ugeskrift for Laeger
Richard Perez, Jamie C Brehaut, Monica Taljaard, Ian G Stiell, Catherine M Clement, Jeremy Grimshaw
BACKGROUND: Clinical decision rules (CDRs) can be an effective tool for knowledge translation in emergency medicine, but their implementation is often a challenge. This study examined whether the Theory of Planned Behaviour (TPB) could help explain the inconsistent results between the successful Canadian C-Spine Rule (CCR) implementation study and unsuccessful Canadian CT Head Rule (CCHR) implementation study. Both rules are aimed at improving the accuracy and efficiency of emergency department radiography use in clinical contexts that exhibit enormous inefficiency at the present time...
2014: Implementation Science: IS
Mohammed Adris Razaq, Terasa Broom
There is some controversy surrounding the optimal mode of imaging in trauma patients with suspected cervical (C) spine injury. Various rules (most notably the Canadian C-spine rules and the NEXUS rules) have been designed to help reduce the need for imaging given the poor yield. Some authorities advocate CT for almost all cases whereas others advocate three view radiographs unless the patient is at high risk, in which case CT is the preferred choice. One meta-analysis showed sensitivity of 58% (39-76%) for plain radiographs and 98% for CT in identification of C-spine injuries following blunt trauma...
2014: BMJ Case Reports
Brent Griffith, Phyllis Vallee, Seth Krupp, Melissa Jung, Michelle Slezak, Jumana Nagarwala, C Patrick Loeckner, Lonni R Schultz, Rajan Jain
PURPOSE: The aim of this study was to determine the effect of a clinical education initiative on the appropriate utilization of screening cervical spine CT in the emergency department. The purpose was to assess if clinical education can produce stricter adherence to the ACR Appropriateness Criteria and improve the utilization of screening CT examinations in the emergency department. METHODS: Institutional review board approval was obtained for this HIPAA-compliant study...
February 2014: Journal of the American College of Radiology: JACR
Zoe A Michaleff, Chris G Maher, Arianne P Verhagen, Trudy Rebbeck, Chung-Wei Christine Lin
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 the need for cervical spine imaging. METHODS: We identified studies by an electronic search of CINAHL, Embase and MEDLINE...
November 6, 2012: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Mark Paxton, Clare F Heal, Herwig Drobetz
INTRODUCTION: Cervical spine radiography may be over-utilised in an emergency department setting. The Canadian C-Spine Rule has been developed to reduce unnecessary radiography. Our aim was to retrospectively determine the proportion of cervical spine radiographs requested through the emergency department for trauma patients that were clinically indicated, according to the Canadian C-Spine Rule. METHODS: This was a cross-sectional survey conducted at a regional centre in Northern Queensland, Australia...
October 2012: Journal of Medical Imaging and Radiation Oncology
Nawfal Al-Hadithy, Arshad Khan, Ashis Banerjee
The authors present a case report of a potentially missed C2 fracture whose signs and symptoms did not warrant radiograph imaging according to both the National Emergency X-Radiography Utilization Study and Canadian C-spine Rules. The patient had a significant injury while rear-ending a stationary vehicle at 20 mph, and the correct diagnosis was only made based on approaching him with a high index of suspicion. He was successfully treated in a halo collar and made an excellent recovery.
2011: BMJ Case Reports
Niamh C Collins, Juliet V McKenzie
The National Emergency X-ray Utilisation Study (NEXUS) criteria and the Canadian cervical spine rules are validated clinical decision-making tools used to facilitate selective cervical spine (C-spine) radiography. The NEXUS criteria are frequently used, as the Canadian cervical spine rules have been noted to be difficult to learn, remember and implement. We present a series of significant C-spine injury in three elderly patients who would not have warranted C-spine imaging using the NEXUS criteria. Each patient was mobile and fully orientated after the injury...
February 2013: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Therèse M Duane, Sean P Wilson, Julie Mayglothling, Luke G Wolfe, Michel B Aboutanos, James F Whelan, Ajai K Malhotra, Rao R Ivatury
BACKGROUND: The Canadian cervical spine rule (CCS) has been found to be an effective tool to determine the need for radiographic evaluation of the cervical spine (c-spine) incorporating both clinical findings and mechanism. Previously, it has been validated only through clinical follow-up or selective use of X-rays. The purpose of this study was to validate it using computed tomography (CT) as the gold standard to identify fractures. METHODS: Prospective evaluation was performed on 3,201 blunt trauma patients who were screened by CCS and were compared with a complete c-spine CT...
August 2011: Journal of Trauma
Christian Vaillancourt, Manya Charette, Ann Kasaboski, Justin Maloney, George A Wells, Ian G Stiell
BACKGROUND: Canadian Emergency Medical Services annually transport 1.3 million patients with potential neck injuries to local emergency departments. Less than 1% of those patients have a c-spine fracture and even less (0.5%) have a spinal cord injury. Most injuries occur before the arrival of paramedics, not during transport to the hospital, yet most patients are transported in ambulances immobilized. They stay fully immobilized until a bed is available, or until physician assessment and/or X-rays are complete...
2011: BMC Emergency Medicine
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