We use the Canadian rules (these have now been validated and are both more
sensitive and more specific than the NEXUS criteria), but allow individuals
to use their own judgement (still). As Andrew says, these are essentially
the NICE guidelines. We allow our nurses to act as professionals, so don't
place any restrictions on what they do other than that they ensure they are
competent to do it. Most of our nurses are still a bit worried around necks,
but some are starting to use the Canadian rules in the more obvious cases
(our ambulance service still use NEXUS).
Unfortunately a lot of our patients are over 65 so have to get x-rays still.
Matt Dunn
Warwick
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