Can emergency nurses use the Canadian cervical spine rule to reduce unnecessary patient immobilisation?

Multicentre prospective validation of use of the Canadian C-Spine Rule by triage nurses in the emergency department

“…That study also demonstrated good inter observer agreement between nurses and physicians and found that the majority of nurses were comfortable in using the rule. 13 Kelly and coworkers, 14 in Australia, also reported good interobserver agreement between nurses and physicians in interpreting the Canadian C-Spine Rule in 88 patients. In another UK study, Pitt and colleagues 15 had emergency nurses attempt to clear the cervical spine of trauma patients using the NEXUS criteria.…”

“…The authors evaluated interobserver agreement for 211 patients and concluded that there was good agreement between nurses and physicians for these assessments. Miller and associates, 13 in a study performed in the United Kingdom, evaluated 112 emergency nurses and their interpretation of the Canadian C-Spine Rule in 460 patients. That study also demonstrated good inter observer agreement between nurses and physicians and found that the majority of nurses were comfortable in using the rule.…”

“…Very little research has been done to determine the ability of nurses to clear immobilization of the cervical spine. [12][13][14][15] Our objective in this study was to prospectively evaluate the accuracy, reliability and acceptability of the Canadian C-Spine Rule when used by nurses to assess patients' need for immobilization.…”

Accuracy of the Canadian C-spine rule and NEXUS to screen for clinically important cervical spine injury in patients following blunt trauma: a systematic review

“…Of the 9 studies that assessed the Canadian Cspine rule, 4 were prospective studies 2,13,21,23 that aimed to assess the rule in its entirety; 4 prospectively applied a modified version of the rule; 19,22,24,25 and 1 was a retrospective study. 20 The sensitivity of the Canadian C-spine rule ranged from 0.90 to 1.0, while the specificity ranged from 0.01 to 0.77 ( Figure 2).…”

“…In the 8 studies that used different reference tests, patients who did not undergo imaging were followed up with either the 14-day proxy 2,13,19,22,23,26 or the 21-day surveillance strategy. 19,21,24 With the 14-day proxy method, patients are contacted by a registered nurse 14 days after discharge and asked 8 questions about pain and return to function. A positive response to these questions resulted in patients being asked to return to hospital for imaging investigations.…”