🦴 NEXUS C-Spine Criteria
UseDecide whether C-spine imaging can be safely avoided after trauma.
StrataIf any NEXUS criterion is present, obtain imaging per trauma protocol; if all are absent in an appropriate pa…
LimitsHigh sensitivity but limited specificity — many patients still need i… · Intoxication and distracting injury are clinical judgements; when uns… · Canadian C-Spine Rule may reduce imaging further in alert GCS-15 pati…
SourceHoffman JR, et al. N Engl J Med 2000
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
Paste the link in Slack, Teams, X, or LinkedIn — the preview image comes from this page’s Open Graph card.
Methodology · worked example, guidelines & full notes
All five must be negative to clear clinically.
When to use
Decide whether C-spine imaging can be safely avoided after trauma.
How it works
Imaging can be deferred only if all are absent: midline tenderness, focal neuro deficit, altered alertness, intoxication, and a distracting injury.
Key points
- All five must be negative to clear clinically.
- Highly sensitive for clinically significant injury.
- Canadian C-Spine Rule is an alternative with higher specificity.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Midline cervical tenderness | Absent |
|---|---|
| Focal neurological deficit | Absent |
| Altered level of alertness | Absent |
| Intoxication | Absent |
| Distracting painful injury | Absent |
→ImagingNo imaging needed
- Rule：If all five criteria are absent, the cervical spine can be cleared clinically.
| Midline cervical tenderness | Present |
|---|---|
| Focal neurological deficit | Present |
| Altered level of alertness | Present |
| Intoxication | Present |
| Distracting painful injury | Present |
→ImagingImaging indicated
- Rule：If all five criteria are absent, the cervical spine can be cleared clinically.
Verification & sources · governance
FAQ
Frequently asked questions
- Does NEXUS C-Spine Criteria upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is NEXUS C-Spine Criteria calculated in practice? Can you show a worked example?
- Inputs: Midline cervical tenderness Absent, Focal neurological deficit Absent, Altered level of alertness Absent, Intoxication Absent, Distracting painful injury Absent → Result: Imaging No imaging needed（Rule: If all five criteria are absent, the cervical spine can be cleared clinically.） Inputs: Midline cervical tenderness Present, Focal neurological deficit Present, Altered level of alertness Present, Intoxication Present, Distracting painful injury Present → Result: Imaging Imaging indicated（Rule: If all five criteria are absent, the cervical spine can be cleared clinically.）