Think about what you do in the ED? Do you recognize how the following studies have impacted your practice?
National Emergency X-Radiography Utilization Study
Multicenter, prospective, observational study of patients with blunt trauma for whom cervical spine X-rays were obtained.
Get C-spine films if:
- Patients with abnormal neurologic examination
- Distracting or painful injury (like a femur fracture)
- Depressed or altered mental status
- Intoxication
- Midline cervical tenderness should get an X-Ray
Canadian C-spine rule
A prospective cohort study in Canada evaluating patients with head or neck trauma.
Radiography in high risk factors
- Dangerous mechanism
- Paresthesias
Assess range of motion in low-risk factors. If ANY of the following are present AND the patient can actively rotate 45 degrees to left and right, then C-spine films may not be needed.
- Simple rear-end MVC
- Sitting position in the ED
- Ambulatory at any time since injury
- Delayed onset neck pain
- Absence of midline C-spine tenderness
Edit: Corrected Canadian C-spine rule to state if ANY of the above 5 items are present