🦴 Canadian C-Spine Rule
Decide on cervical-spine imaging after trauma with the Canadian C-Spine Rule.
Canadian C-Spine Rule
Any high-risk factor (age ≥ 65, dangerous mechanism, or paraesthesias in extremities)
Any low-risk factor allowing safe assessment (simple rear-end MVC, sitting in ED, ambulatory, delayed neck pain, or no midline tenderness)
Able to actively rotate neck 45° left and right
When to use
Reduce unnecessary C-spine imaging in alert, stable patients.
How it works
Image if any high-risk factor is present; otherwise, if a low-risk factor permits safe assessment of rotation, clear if the patient can rotate the neck 45° each way.
Key points
- Applies to alert (GCS 15), stable trauma patients.
- Very high sensitivity for significant injury.
- More specific than NEXUS, reducing imaging.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.