EBQ:NEXUS cervical trauma rule: Difference between revisions
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The NEXUS C-spine rule is a highly sensitive decision rule used to determine the need for radiography in patients with blunt trauma. | The NEXUS C-spine rule is a highly sensitive decision rule used to determine the need for radiography in patients with blunt trauma. | ||
==Major Points== | ==Major Points== | ||
Five Main Questions: | |||
#Is a focal neurologic deficit present? | |||
#Is there midline spinal tenderness? | |||
#Does the patient have altered mental status? | |||
#Is the patient intoxicated? | |||
#Does the patient have an apparent distracting injury? | |||
If the answer is "yes" to any of these questions, imaging in recommended. | |||
Rule had 99% sensitivity and 12.9% specificity for identifying 810 patients with cervical spine injury. | |||
==Study Design== | ==Study Design== | ||
Revision as of 18:03, 2 September 2015
incomplete Journal Club Article
Hoffman JR, Mower WR, Wolfson AB, Todd KH, Zucker MI.. "Validity of a Set of Clinical Criteria to Rule Out Injury to the Cervical Spine in Patients with Blunt Trauma. National Emergency X-Radiography Utilization Study Group.". N Engl J Med. 2001. 343(2):94-9.
PubMed Full text PDF
PubMed Full text PDF
Clinical Question
Can a clinical decision rule be used to evaluate the need for radiography of the cervical spine after blunt trauma?
Conclusion
The NEXUS C-spine rule is a highly sensitive decision rule used to determine the need for radiography in patients with blunt trauma.
Major Points
Five Main Questions:
- Is a focal neurologic deficit present?
- Is there midline spinal tenderness?
- Does the patient have altered mental status?
- Is the patient intoxicated?
- Does the patient have an apparent distracting injury?
If the answer is "yes" to any of these questions, imaging in recommended.
Rule had 99% sensitivity and 12.9% specificity for identifying 810 patients with cervical spine injury.
Study Design
- Multicenter, prospective, observational study of ED patients with blunt trauma for whom cervical spine imaging is ordered.[1]
Population
Patient Demographics
Inclusion Criteria
Exclusion Criteria
Interventions
Outcomes
Primary Outcome
Secondary Outcomes
Subgroup analysis
Criticisms & Further Discussion
External Links
Funding
References
- ↑ Hoffman JR, Wolfson AB, Todd K, Mower WR. Selective cervical spine radiography in blunt trauma: methodology of the National Emergency X-Radiography Utilization Study (NEXUS). Ann Emerg Med. 1998 Oct;32(4):461-9.