>Trauma Surgery >NEXUS-criteriaAuthor: J. Sprakel, MD - Latest update: 07-12-2014


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National Emergency X-Radiography Utilization Study (NEXUS) criteria

- No posterior midline neck pain or tenderness
- No focal neurological deficit
- Normal level of alertness
- No evidence of intoxication
- No clinical apparant, painful distracting injury *

* a condition thought by the clinician to be producing pain sufficient to distract the patients from a second (neck) injury.
Examples may include, but are not limited to the following:
       1. a long bone fracture
       2. a visceral injury requiring surgical consultation
       3. a large laceration, degloving injury, or crush injury
       4. large burns
       5. or any ther injury producing acute functional impairment
Physicians may also classify any injury as distracting if it is thought to have the potential to impair the patients ability to appreciate other injuries

Ability to detect clinical significant C-spine injury: Sensitivity: 99,6% - Specificity 12,6%
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1. Hoffman JR, Mower WR, Wolfson AB, Todd KH, Zucker MI. Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. National Emergency X-Radiography Utilization Study Group. N Engl J Med. 2000 Jul 13;343(2):94-9. Erratum in: N Engl J Med 2001 Feb 8;344(6):464.