1. SSC 1 Audit Abstract M5724
AN AUDIT OF CANADIAN C-SPINE RULE (CCSR)
FOR CERVICAL SPINE IMAGING IN ALERT AND
STABLE TRAUMA PATIENTS AT THE HOSPITAL
SULTANAH AMINAH (HSA)
Abstract
Background:
High discrepancy and inefficiency exist in clinical practice regarding the use of cervical spine radiography
in alert and stable trauma patients. Insufficient investigation might underdiagnose C–spine injury while
unnecessary imaging wastes department’s resources and affects patient safety. CCSR has high sensitivity
and reliability to rule out C-spine injury in these patients.
Aim:
To assess adherence of HSA to the CCSR on using imaging in stable and alert trauma patients with
suspected C-spine injury.
Methods:
Prospective study of new traumatic cases between 11/1/2015-6/2/2015
 The sample comprised of patients who met the CCSR criteria
 Data was collected from hospital records by using pro-forma
 Data was analysed to determine whether the decision on imaging was ‘mandatory’ or
‘unnecessary’ according to the CCSR; results of imaging were analysed to determine the
presence of significant C-spine injury
Results:
31 adults (>16 years old) were included in the audit (male=21, female=10, mean age=28.1years).
According to the CCSR guidelines, 14 patients were classified as high-risk while 17 patients were classified
as low-risk. All low-risk patients were able to carry out active neck motion.
 85.7% of high-risk patients and 70.6% of low-risk patients went for imaging
 1/14 had identifiable cervical injury while none of the low-risk patients’ images showed
significant injury
 Only 17/31 fulfilled the CCSR guidelines
Conclusions:
There were high-risk patients who did not receive appropriate imaging while imaging was overdone in
the low-risk group. The audit shows that the current clinical practice at the HSA does not follow the CCSR
guidelines.
(249 words)