NEXUS cervical spine rule: Difference between revisions
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==Background== | ==Background== | ||
*Inclusion criteria is blunt trauma | *Inclusion criteria is [[blunt neck trauma]] | ||
*99.6% sensitive for a clinically important injury (only 12.9% Sp) | *99.6% sensitive for a clinically important injury (only 12.9% Sp) | ||
*Only 8.6% of patients were elderly in the initial study; use caution in applying to elderly | *Only 8.6% of patients were elderly in the initial study; use caution in applying to elderly | ||
**Nexus does not risk stratify based on age like CCR | **Nexus does not risk stratify based on age like CCR | ||
**Small studies show elderly | **Small studies show elderly patients with c-spine fractures do not often have midline tenderness | ||
== | ==Workup== | ||
{{C-spine NEXUS}} | |||
# | |||
# | Mnemonic - ''NSAID'': | ||
#'''N'''euro deficit | |||
# | #'''S'''pinal midline tenderness in C-spine | ||
# | #'''A'''lertness | ||
#'''I'''ntoxication | |||
#'''D'''istracting injury | |||
==See Also== | ==See Also== | ||
*[[Blunt neck trauma]] | |||
*[[C-Spine X-Ray]] | *[[C-Spine X-Ray]] | ||
*[[ | *[[Cervical spine clearance]] | ||
*[[Canadian cervical spine rule]] | |||
*[[EBQ:Canadian C-spine Rule Study]] | |||
*[[EBQ:NEXUS]] | |||
==External Links== | |||
*[http://www.mdcalc.com/canadian-c-spine-rule/ MDCalc Canadian C-Spine Rule] | |||
*[http://www.mdcalc.com/nexus-criteria-for-c-spine-imaging/ MDCalc NEXUS] | |||
== | ==References== | ||
<References/> | |||
[[Category:EMS]] | |||
[[Category:Orthopedics]] | |||
[[Category:Radiology]] | |||
[[Category:Trauma]] | [[Category:Trauma]] | ||
Latest revision as of 20:24, 1 January 2017
Background
- Inclusion criteria is blunt neck trauma
- 99.6% sensitive for a clinically important injury (only 12.9% Sp)
- Only 8.6% of patients were elderly in the initial study; use caution in applying to elderly
- Nexus does not risk stratify based on age like CCR
- Small studies show elderly patients with c-spine fractures do not often have midline tenderness
Workup
NEXUS Cervical Spine Rule
Radiography is not necessary if the patient satisfies ALL of the following low risk criteria:
- No midline cervical tenderness
- No focal neuro deficits
- Normal alertness
- No intoxication
- No painful distracting injury
C-spine imaging should be considered unless the patient meets all of the above low risk criteria[1] [2]
Mnemonic - NSAID:
- Neuro deficit
- Spinal midline tenderness in C-spine
- Alertness
- Intoxication
- Distracting injury
See Also
- Blunt neck trauma
- C-Spine X-Ray
- Cervical spine clearance
- Canadian cervical spine rule
- EBQ:Canadian C-spine Rule Study
- EBQ:NEXUS