![]() Detecting cervical spine stability at the time of injury with the reduced consciousness that typically accompanies major trauma incidents is challenging. In developed countries, the incidence of traumatic spinal injury is decreasing, but the same is not true for developing countries, in which the total numbers remain high and are largely caused by traffic accidents and falling from heights. Ĭervical spine injuries occur frequently in cases of major trauma. According to statistical analysis, 13 million trauma patients are treated annually with the possibility of cervical spinal cord injury in the United States and Canada. Blunt trauma is among the most dangerous types of trauma due to the likelihood of damage in various organs, such as the neck and spinal cord. Trauma cases are definitively the most common cause of hospital emergency department visits. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All relevant data are within the paper and its Supporting Information files.įunding: This research was funded by the emergency research team, Tabriz University of Medical Sciences. Received: SeptemAccepted: OctoPublished: November 2, 2018Ĭopyright: © 2018 Ala et al. Hawryluk, University of Utah Hospital, UNITED STATES doi:10.Citation: Ala A, Shams Vahdati S, Ghaffarzad A, Mousavi H, Mirza-Aghazadeh-Attari M (2018) National emergency X-radiography utilization study guidelines versus Canadian C-Spine guidelines on trauma patients, a prospective analytical study. The Canadian C-spine rule versus the NEXUS low-risk criteria in patients with trauma. Stiell IG, Clement CM, McKnight RD, Brison R, Schull MJ, Rowe BH, Worthington JR, Eisenhauer MA, Cass D, Greenberg G, MacPhail I, Dreyer J, Lee JS, Bandiera G, Reardon M, Holroyd B, Lesiuk H, Wells GA. The Canadian C-spine rule for radiography in alert and stable trauma patients. Stiell IG, Wells GA, Vandemheen KL, Clement CM, Lesiuk H, De Maio VJ, Laupacis A, Schull M, McKnight RD, Verbeek R, Brison R, Cass D, Dreyer J, Eisenhauer MA, Greenberg GH, MacPhail I, Morrison L, Reardon M, Worthington J. There is debate over whether the NEXUS criteria or the Canadian C-spine rules (CCR) are more reliable for excluding C-spine injury, though high-quality evidence points to better sensibility, better sensitivity, and a lower rate of imaging use when following the CCR criteria 3. The original study presented 100% sensitivity for identifying "clinically important C-spine injuries" (95 percent confidence interval 98%-100%). then cervical spine imaging is warranted.if low-risk injury and the patient cannot rotate the neck 45°.if low-risk injury and the patient can rotate the neck 45°.If the patient meets the criteria of a low-risk injury, then one should assess on physical exam whether the patient can rotate the neck 45°. If the patient does not meet the criteria of a low-risk injury, then cervical spine imaging is warranted. ambulatory at any time since the injury.sitting position in emergency department.excludes being hit by a high-speed vehicle, a large vehicle (e.g.simple rear-end motor vehicle collision.If any high-risk factor is present, then cervical spine imaging is warranted. >100 km/hr or ~60 mph, rollover, ejection) high-speed motor vehicle collision (e.g.fall from elevation >3 ft (or 5 stairs).is there any high-risk factor present that requires cervical spine imaging?.Canadian C-spine rules are a set of guidelines that help a clinician decide if cervical spine imaging is not appropriate for a trauma patient in the emergency department.
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