Case challenge · Emergency / Trauma / Radiology · teaching

Cervical Spine Clearance (NEXUS/Canadian) — Pathway · case challenge

Given a case, work through the care pathway step by step; the tool checks each choice and scores you. Decisions and basis are taken from this site's reviewed care pathways.

← View the full flowchartBased on NEXUS / CCR

Case #1Emergency / Trauma / Radiology

📋 Case data

Can the c-spine be cleared clinically?All low-risk criteria met

Data is taken from this pathway's reviewed node text. Work through the pathway step by step.

Step 1 / 1 · Can the c-spine be cleared clinically?

Blunt trauma — can the cervical spine be cleared clinically?

💡 Maintain c-spine immobilization until cleared. NEXUS (sensitivity ~99%): if all 5 low-risk criteria are met, no imaging is needed — 1) no posterior midline cervical tenderness; 2) no focal neurological deficit; 3) normal alertness (GCS 15); 4) no evidence of intoxication; 5) no painful distracting injury. The Canadian C-spine Rule (CCR, for the alert and stable) adds high-risk features (age ≥65/dangerous mechanism/extremity paresthesias) and the ability to actively rotate the neck 45°.

For teaching. Decisions and their basis are taken from this site's reviewed care pathways; for licensed clinicians/trainees, this does not replace clinical judgment or local protocols.