Suzanne Mason wrote:
> Hi jel. I am sure ian would be happy to be contacted.
I have just emailed him - thanks for this and to Rowley for providing
> I know they have done some work on using the rule in PHC settings. Jonathan benger in Bristol has also written a paper about PHC use which I think was in the european journal. An academic fellow of mine has also done a systematic review which you might find helpful. I will try + send it on next week as on my way to holidays just now!
Yes please :)
Thanks to all who have replied.
Can I re-ask my supplementary question though, please - how many folks
are using the Canadian C-spine Rule in the UK? (_and_ thus x-raying
just based on the mechanism of injury as is suggested).
> Sue mason
> Sent from my BlackBerry® wireless device
> -----Original Message-----
> From: Andrew Webster <[log in to unmask]>
> Date: Sat, 29 May 2010 07:06:01
> To: <[log in to unmask]>
> Subject: Re: Canadian C-spine rule
> At the end of the day my viewpoint is that you need to use clinical
> acumen as well. Taking other factors into account. This I the problem
> of calling them clinical decision rules as if they should be followed.
> I think Some EBM experts prefer them to be called clinical decision
> tools or instruments as something to aid decision making. I tend to
> use NEXUS with the addition of ROM >45 degrees. In association with
> On 29 May 2010, at 03:59, Jel Coward <[log in to unmask]> wrote:
>> Hi all
>> ......I know, I know, I'm brain picking again.....sorry.
>> There is a thing called the Canadian C-spine Rule.
>> We are trying to come up with some guidelines for practice in the
>> Canadian rurality, which as I am sure you can imagine, can be quite
>> I have a problem with the Canadian C-spine Rule in that it mandates
>> c-spine xray (for many of us, immobilisation and transfer to a
>> facility that has 24 hour x-ray - perhaps hours away - perhaps a
>> flight away) based on _dangerous mechanism of injury_ alone.
>> It describes a 'dangerous mechanism' as being
>> - fall > 3 ft / 5 stairs
>> - axial load to head eg. diving
>> - MVC high speed (>100km/hr), rollover, ejection
>> - motorised recreational vehicles (snowmobiles, ATVs, I think is
>> - bicycle collision
>> It _mandates_ (it labels itself a Rule) - radiography of the neck
>> for all of the above.
>> Which seems a bit daft. I not infrequently see the ATV rollover guy
>> or gal who rolls their machine in the hills, rights it, gets back
>> on, rides out and comes in because they thing they sprained their
>> thumb when it happens - otherwise asymptomatic and meeting NEXUS
>> criteria - or similar scenarios.
>> I have a colleague saying 'no, no, no we must use the Canadian C-
>> spine rule in our teaching because it is the only 'rule' based on a
>> _prospective_ study'.
>> So.......how far off am I suggesting that we do what many ambulance
>> services do, and emerg depts (I think) do - and use a clinical
>> criteria based assessment tool rather than one that mandates x-ray
>> based on 'what happened' (and not necessarily, what happened to the
>> patient, either).
>> Thoughts would be very welcome please - either way.
>> Lastly - is the Can C-spine rule being used much in the UK and
>> Thanks all :)
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