Cervical Spine Injury CCS Rule

MCEM Part B and C frequently tests you on this:

When do you do an imaging for cervical spine injury (High Risk Patients)

1  Age > 65
2  High Risk Mechanism of Injury:
    a  Fall from 3 ft or 5 stairs,
    b  High Speed collision > 100 kmph,
    c  Rollover accident, and
    d  Ejection injury
3  Paresthesia in upper limbs
4  Altered level of conciousness (Drug/alcohol abuse)

Low risk Patients

1  Simple rear end collision
2  Delayed onset of pain
3  Ambulatory at any time post event
4  Sitting in the ED
5  No spinal midline tenderness

If any of these present, ask patient to move his neck in 45 degrees to left or right, if that is possible then NO Imaging.