The document summarizes the Canadian C-Spine Rule, a 3-step assessment tool used to determine if cervical spine imaging is needed for patients with potential cervical spine injury. Step 1 evaluates for high-risk factors like age over 65 or dangerous mechanism of injury that mandate imaging. Step 2 examines low-risk factors like minor car collisions or no neck tenderness that allow range of motion testing. Step 3 performs active rotation testing, with inability to rotate 45 degrees requiring imaging. The tool helps determine which low-risk patients do not need radiography to rule out cervical spine injury.

1. CANADIAN C - SPINE RULE
JABEZ

2. Canadian C-Spine Rule
The Canadian C-Spine Rules (CCR) is an
assessment tool used to rule out cervical
spine injury in low-risk patients, obviating
the need for radiography.
The Canadian C-Spine Rule is applicable to patients who are in an
alert and stable condition following trauma where cervical spine injury
is a concern

3. Creator Of Canadian C-Spine Rule
Dr.Ian Stiell, MD, MSc, FRCPC, is Professor and
Chair, Department of Emergency Medicine, University of Ottawa;
Distinguished Professor and University Health Research Chair,
University of Ottawa; Senior Scientist, Ottawa Hospital Research
Institute; and Emergency Physician, The Ottawa Hospital.

5. Step 1
Is there any high-risk factor that mandates radiography? These include
the following:
* Age older than 65 years.
* Mechanism of injury considered dangerous.
* Numbness or tingling present in the
extremities .

6. EXAMPLE FOR STEP 1 :
A dangerous mechanism of injury would be, for example, a fall from an
elevation of 3 feet or higher, a bicycle collision, an axial load to the head
(eg, resulting from a dive into an empty swimming pool), or a motor
vehicle collision involving high speed, rollover, or ejection.
If the answer to any of these is yes, the patient is at risk for having a
cervical spine injury and neck radiography should be performed.
Otherwise, proceed to step 2.

7. Step 2
Are there any low-risk factors that
indicate safe assessment of range of
motion? They are as follows:
* Simple rear-end motor vehicle collision.
* Patient ambulatory at any time since
injury.
* Delayed onset of neck pain .
* Patient in sitting position in emergency
department .
* Absence of midline cervical spine
tenderness .
If none of these low-risk factors is present, the patient is at risk for having
a cervical spine injury and neck radiography should be performed.
Otherwise, proceed to step 3.

8. Step 3
Is the patient able to actively rotate his or
her neck 45° left and right?
If no, the patient is at risk for having a
cervical spine injury and neck radiography
should be performed. If yes, radiography is
not performed.

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