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NEXUS cervical spine rule
From WikEM
(Redirected from C-Spine (NEXUS))
Contents
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
External Links
References
- ↑ 27. Hoffman JR, et al. Low-risk criteria for cervical-spine radiography in blunt trauma: a prospective study. Ann Emerg Med 1992;21:1454-60.
- ↑ Mahadevan, et al. Interrater reliability of cervical spine injury criteria inpatients with blunt trauma. Ann Emerg Med1998;31:197-201
