Assessing and Clearing the Cervical Spine Case 2

Assessing and Clearing the Cervical Spine Case 2

  1. 1. Question

    A 37-year-old lady attends the emergency department following a road traffic accident in which she was rear shunted into the car in front. She was stationary at the time of the accident and was wearing a seat belt. She is complaining of neck pain. She has been “boarded and collared” by the attending paramedics. On examination she has some left sided paravertebral soft tissue tenderness and no neurological signs.

    You feel that the risk of significant injury is low and are keen to clinically clear her neck.

    Considering the Canadian Cervical Spine Rule for determining the need for an X-ray, please drag and drop the following criteria on the left into the appropriate high risk or low risk boxes.

    Sort elements
    • Simple rear-end MVC, Sitting position in the ED, Ambulatory at any time, Delayed onset of neck pain, Absence of midline c-spine tenderness
    • Age > 65 years, Bicycle collision, MVC with rollover or ejection, Axial load to head e.g. diving, Fall > 1 metre / 5 stairs, Parasthesiae in the extremities
    • High risk
      • Low risk
      • 2. Question

        Which one of the following factors in her case are associated with a poorer prognosis with regard to neck sprain?

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      • 3. Question

        Considering the Nexus Low Risk Criteria, which of the following factors, if present, would mandate further imaging for this lady (select as many as are applicable)?

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