Canadian C-Spine Rule
Determines need for C-spine imaging in alert, stable trauma patients. More sensitive and specific than NEXUS.
Score interpretation
Canadian C-Spine Rule: C-spine imaging NOT required. No high-risk factors, low-risk factor present, and able to rotate.
→ C-spine can be clinically cleared. Document assessment. Soft collar not routinely needed.
Canadian C-Spine Rule: C-spine imaging REQUIRED.
→ Maintain C-spine immobilisation. CT C-spine (preferred over plain XR in significant mechanism). Ortho/Neuro review if abnormality found.
Interpretation bands for the Canadian C-Spine. Apply clinical judgement and local guidance.
References
- Stiell IG et al. The Canadian C-spine rule for radiography in alert and stable trauma patients. JAMA. 2001.
- Stiell IG et al. The Canadian C-spine rule versus NEXUS low-risk criteria in patients with trauma. N Engl J Med. 2003.
Related
Curated clinical cross-links plus same-class fallbacks.
- Tranexamic Acid (ICU/Trauma/Surgical) · Antifibrinolytic
- Dinoprostone (Cervical Ripening / Induction of Labour) · Prostaglandin E2 (Cervical Ripening / Induction of Labour)
- Bupivacaine (Orthopaedic Nerve Blocks) · Local Anaesthetic — Long-acting Amide
- Risdiplam · SMN2 Splicing Modifier (Spinal Muscular Atrophy — Oral)
- Tranexamic Acid (Surgical / Trauma Haemorrhage) · Antifibrinolytic (Haemostatic)
- Bupivacaine · Long-Acting Local Anaesthetic (Amide)
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Major Haemorrhage Protocol · NICE NG24; UK MHP guidelines
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.