C-Spine Clearance
Minimize unnecessary imaging while safely clearing cervical spine motion restriction.
Updated: 05/04/2025
C-spineSMRCTNSGYOn this page3 sectionsHide sections
✅Evaluable Patient — Clinical Clearance
▼ALL required to be evaluable:
- Age <65
- GCS 15, not intoxicated
- No language barrier
- No significant distracting injury
Normal exam (ALL required to remove collar):
- Normal active ROM
- No midline cervical tenderness
- No focal neurologic deficit
- No spinal deformity
🔴CT Required If Criteria Not Met
▼No fracture, tender
Spine consult. Neck pain ≠ emergent MRI. Defer to spine.
Acute fracture
Continue SMR. IP consult + call NSGY. Most C-spine fx → also get CTA neck (BCVI CPG).
Neuro deficit
STAT MRI. IP consult + call NSGY attending. Notify Trauma Attending.
Unexaminable, CT negative
Collar may be discontinued. Use caution with severe degenerative disease — discuss with the Trauma Attending first.
ℹ️
Significant blunt mechanism → cervical SMR with rigid collar on admission. No SMR for penetrating trauma unless directed by Trauma Attending or NSGY.
🔬Decision Rule Calculators — NEXUS & Canadian C-Spine Rule
▼- Status
- AHS Official Protocol
- Source
- C_Spine_Clearance_2025.docx
- Last reviewed / updated
- 05/04/2025