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Canadian C Spine Rule
Aug 12, 2013
•
Mark Morgan
categories:
Musculoskeletal & Rheumatology
Canadian C-Spine Rule
Summary: Evaluate for need of C-spine Xray. This applies the Canadian C-Spine Rule to determine whether Xray is recommended.
High Risk Factors
no
YES
<-- Age: 65 years or older
no
YES
<-- Has paresthesia in the extremities
no
YES
<-- Fall from at least 3 feet or 5 stairs
no
YES
<-- Axial load to the head, such as when diving
no
YES
<-- Motor vehicle collision at high speed (at least 62 mph)
no
YES
<-- Motor vehicle collision with ejection or rollover
no
YES
<-- Collision involving motorized recreational vehicle or bicycle
Low Risk Factors
yes
NO
<-- Able to sit up in the emergency room
yes
NO
<-- Ambulatory at any time
yes
NO
<-- Delayed onset of neck pain
yes
NO
<-- No midline C-spine tenderness
yes
NO
<-- Simple rear-end collision
yes
NO
<-- Not hit by bus or large truck, rollover, or hit by a vehicle moving at high speed
NOTE: Range of motion is safely assessed (safe if at least ONE low risk factor is present)
yes
NO
<-- Patient is able to actively rotate neck 45 degrees to the left and right
Interpretation
score=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9)+(Qten)+(Qeleven)+(Qtwelve)+(Qthirteen)+(Qfourteen);score>9?'Canadian C-Spine Rule recommends obtaining X-ray':score>0?'Canadian C-Spine Rule supports not obtaining X-ray':'Canadian C-Spine Rule recommends obtaining X-ray'
display/hide references
reference:
#1
Ebell (2006) Am Fam Phys 73:1787-1788
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