Clinical decision-support only — does not replace attending supervision or institutional policy
NEXUS C-Spine
NEXUS clinically clears cervical spine injury without imaging only when all five NSAID criteria are absent.
Because NEXUS performance is less certain in older adults, consider a lower threshold for imaging in patients over 65 when mechanism or exam is concerning.
If imaging identifies clinically significant C-spine injury: maintain cervical spine protection with an appropriate collar, consult neurosurgery, keep the patient non-ambulatory and NPO until the treatment plan is complete, and consider operative stabilization or neurosurgical ICU admission as clinically indicated.
NEXUS C-Spine Result
LOW RISK — C-spine can be cleared clinically by NEXUS
No focal neurologic deficit, no posterior midline cervical tenderness, normal alertness, no intoxication, and no distracting injury. Further imaging is likely unnecessary when the rule is applied appropriately.
These calculators support clinical decision-making and education. They do not replace physician judgment, institutional protocols, or attending guidance.
Clinical decision-support only — does not replace attending supervision or institutional policy