NEXUS + Canadian C-Spine
NEXUS + Canadian C-Spine - a deterministic tool in Sophie Well's EMS & Field Medicine group.
Open the NEXUS + Canadian C-Spine → Runs in your browser. No signup, no tracking.
What this is
Apply the two validated clinical-decision rules for cervical-spine imaging in alert blunt-trauma patients - NEXUS (no posterior midline tenderness, no intoxication, normal alertness, no focal neurologic deficit, no painful distracting injury) and the Canadian C-Spine Rule (age, mechanism, neck rotation, low-risk features). Sophie Well takes the shared inputs once and reports whether each rule clears the patient for clinical exam alone or recommends imaging.
When to use it
Use this when an awake blunt-trauma patient presents with neck pain or a concerning mechanism and you want to document the rationale for or against c-spine imaging. Both rules are highly sensitive for clinically important cervical-spine injury and can spare imaging in a large fraction of low-risk presentations - the documentation is the protective layer. Neither rule applies to obtunded patients, age extremes outside their derivation cohorts, or polytrauma where a distracting injury cannot be ruled out; in those cases imaging proceeds on clinical grounds regardless of what the rules say.
References
Hoffman JR, et al. NEXUS criteria. NEJM. 2000;343(2):94-99. Stiell IG, et al. Canadian C-Spine Rule. JAMA. 2001;286(15):1841-1848.
Worked example: All five low-risk criteria met -> NEXUS: cervical spine imaging NOT required.
Sophie Well is a reference and educational tool. Not medical, legal, or financial advice. Does not replace clinician judgment, professional billing review, or legal counsel.