Canadian C-Spine Rule

Original Editor - Josh McCormack 

Top Contributors - Admin, Josh McCormack, Rachael Lowe, Kim Jackson, Elaine Lonnemann, Laura Ritchie, WikiSysop, Simisola Ajeyalemi, Claire Knott, Olajumoke Ogunleye, Selena Horner, Evan Thomas, Naomi O'Reilly and Shaimaa Eldib  

Purpose

The Canadian C-Spine Rule (CCR) is a decision making tool used to determine when radiography should be utilized in patients following trauma.

Population

The Canadian C-Spine Rule is applicable to patients who are in an alert (Glasgow Coma Scale score of 15) and stable condition following trauma .

It is not applicable in non-trauma cases, if the patient has unstable vital signs, acute paralysis, known vertebral disease or previous history of Cervical Spine surgery and age <16 years. 

Important Definitions 

Dangerous mechanism: fall from 3 feet or 5 stairs, an axial load to the head, high speed MVA (>100km/h; 62/mph) or with rollover or ejection, a collision involving a motorized recreational vehicle, a collision involving a bicycle.

A simple rear-end collision exludes: being pushed into oncoming traffic, being hit by a bus or large truck, a rollover, being hit by a high speed vehicle.

Usefulness

Sn= 99.4 Sp=45.1  

Negative Likelihood Ratio associated with this highly sensitive test is less than 5%.  This means there is only a 5% chance that if you get a negative finding for this test, the patient would still have the condition.

Recent Related Research (from Pubmed)

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