{"id":12023,"date":"2022-10-13T10:11:19","date_gmt":"2022-10-13T08:11:19","guid":{"rendered":"https:\/\/www.physiotutors.com\/?post_type=wiki&p=12023"},"modified":"2022-10-13T10:11:19","modified_gmt":"2022-10-13T08:11:19","slug":"canadian-c-spine-rules","status":"publish","type":"wiki","link":"https:\/\/www.physiotutors.com\/wiki\/canadian-c-spine-rules\/","title":{"rendered":"Canadian C-Spine Rules"},"featured_media":12024,"template":"","class_list":["post-12023","wiki","type-wiki","status-publish","has-post-thumbnail","hentry"],"acf":{"sections":[{"acf_fc_layout":"page-header-detail-page","background":{"background_image":12024,"background_image_alt_text":"Canadian C-Spine Rules"},"heading":"Canadian C-Spine Rules | Cervical Fracture Screening","subheading":"Screening","content_editor":"","button_type":"internal_link","button_label":"Check our shop","button_style":"button-five","button_internal_link":"","button_anchor":"","button_url":"","button_file":"","label":""},{"acf_fc_layout":"submenu","links":[{"button_type":"anchor","button_label":"Learn","button_internal_link":null,"button_anchor":"section-number-3","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Assessment E-Book","button_internal_link":null,"button_anchor":"section-number-4","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Reviews","button_internal_link":null,"button_anchor":"section-number-5","button_url":"","button_file":null}],"dropdown_label":"Go to","button_right":{"button_type":"internal_link","button_label":"Become a member","button_style":"button-three","button_internal_link":16662,"button_anchor":"","button_url":"","button_file":""},"button_description":"Find this wiki on the Physiotutors platform"},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"

Learn<\/h4>"},"column_right":{"content_editor":"

Canadian C-Spine Rules | Cervical Fracture Screening<\/h2>\nAfter blunt trauma to the head, it is essential to screen for fractures, dislocation, or ligamentous instability in the cervical spine, which would require specialist follow-up with possible surgical intervention as these injuries can have fatal consequences ranging from spinal cord injury to death if they are not detected.\u00a0<\/span>\n\nThe Canadian C-Spine rules are a clinical decision rule that\u2019s used to safely rule out cervical spine fractures in alert, stable patients without the need for radiographic imagery.<\/span>\n\nA review by Michaleff et al. (2012)<\/a> found values of sensitivity ranging from\u00a0 90-100% and specificity ranging from\u00a0 1-77%. <\/span>\n
\n\n[embed]https:\/\/www.youtube.com\/watch?v=F4AbC9FQ-sA[\/embed]\n\n<\/div>\nSo first you want to clear any high-risk factors which would mandate radiography<\/span>\n\nRadiography is indicated for patients who are 65 or older, patients who have paresthesias in the extremities, or if the trauma had a dangerous mechanism which are:<\/span>\n
    \n \t
  1. falls from more than 3 feet of height or 5 stairs,<\/span><\/li>\n \t
  2. axial load on the head such as during diving<\/span><\/li>\n \t
  3. a motor vehicle accident at high speeds (more than 100km\/h or 60mph), rollover accidents, or being ejected from the vehicle<\/span><\/li>\n \t
  4. an accident using motorized recreational vehicles<\/span><\/li>\n \t
  5. or a bicycle accident<\/span><\/li>\n<\/ol>\nIf these factors are not present, check if the following low-risk factors apply, allowing safe assessment of range of motion. These are:<\/span>\n
      \n \t
    1. The accident was a simple rear-end collision (these exclude being pushed into oncoming traffic or when being hit by a truck or bus or at high speeds as well as rollover accidents)<\/span><\/li>\n \t
    2. the patient is able to sit in the emergency department<\/span><\/li>\n \t
    3. the patient is ambulatory at any time<\/span><\/li>\n \t
    4. there was a delayed onset of neck pain (meaning no immediate neck pain after the trauma)<\/span><\/li>\n \t
    5. there is no tenderness over the midline at the cervical spine<\/span><\/li>\n<\/ol>\nIf these do not apply, refer out for radiographs. Otherwise, continue by asking the patient to actively rotate the neck.\u00a0<\/span>\n\nIf they are not able to rotate 45\u00b0 left and right, refer out for radiographs.\u00a0 If they are able to do so, then no radiographs are needed. <\/span>\n\n \n\n[cta]\n\n \n\nAnother common screening tool for cervical fractures are the NEXUS criteria<\/a>. If you want to screen for fractures in other body parts, check out the list below:\n