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
- Midline cervical tenderness should get an X-Ray
Canadian C-spine rule
A prospective cohort study in Canada evaluating patients with head or neck trrauma.
Radiography in high risk factors
- Dangerous mechanism
Assess range of motion in low-risk factors. If none 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