NEXUS cervical spine rule: Difference between revisions

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*Inclusion criteria is blunt trauma to the cervical spine
*Inclusion criteria is blunt trauma to the cervical spine
*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
**Nexus does not risk stratify based on age like CCR
**Small studies show elderly pts with c-spine fractures do not often have midline tenderness


==Rule==
==Rule==

Revision as of 17:43, 19 September 2011

Background

  • Inclusion criteria is blunt trauma to the cervical spine
  • 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 pts with c-spine fractures do not often have midline tenderness

Rule

Radiography is Unnecessary if pts satisfy ALL 5 of the following low risk criteria:

  1. No midline cervical tenderness
  2. No focal neuro deficits
  3. Normal alertness
  4. No intoxication
  5. No painful distracting injury

See Also

Source

Cervical Spine Injury. EB Medicine April, 2009