cervical spine (C-spine) clearance
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Radiology
- plain film of cervical spine may be prudent
- if NEXUS criteria or Canadian C-spine rule negative, CT is not necessary[2]
- CT of cervical spine if patient is obtunded[5]
- MRI not cost-effective if CT is negative[5]
Management
- the patient must be awake & lucid
- negative cervical spine X-rays
- assess for paresthesias, sensory loss
- assess for muscle weakness
- palpate C-spine
- assess for bone pain
- muscle pain not as important
- move head from side to side
- touch chin to chest
- neck extension
More general terms
Additional terms
References
- ↑ Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 79-80
- ↑ 2.0 2.1 Schuur JD et al. A top-five list for emergency medicine: A pilot project to improve the value of emergency care. JAMA Intern Med 2014 Feb 17 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24534899 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=1830019
- ↑ MD+CALC: NEXUS Criteria for C-Spine Imaging http://www.mdcalc.com/nexus-criteria-for-c-spine-imaging/
- ↑ Stiell IG et al The Canadian C-Spine Rule versus the NEXUS Low-Risk Criteria in Patients with Trauma. N Engl J Med 2003; 349:2510-2518 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/14695411 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa031375
- ↑ 5.0 5.1 5.2 Wu X, Malhotra A, Geng B et al Cost-effectiveness of Magnetic Resonance Imaging in Cervical Clearance of Obtunded Blunt Trauma After a Normal Computed Tomographic Finding. JAMA Surg. 2018 Mar 14. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29541757
Patel MB, Como JJ, Haut ER. The Devil Is in the Details When Removing Cervical Collars After Blunt Trauma. JAMA Surg. 2018 Mar 14. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29541768