What is spinal clearance?

What is spinal clearance?

Clearance of C-Spine: A clinical decision suggesting the absence of acute bone related, ligamentous and neurologic abnormalities of the cervical spine based on history, physical exam and/or negative radiologic studies.

Does MRI C spine need contrast?

Magnetic resonance imaging (MRI) of the spine uses radio waves, a magnetic field and a computer. It creates clear, detailed pictures of the spine and surrounding tissues. MRI does not use radiation and may require an injection of gadolinium contrast material.

How do you rule out C spine?

According to the NEXUScriteria, a patient undergoing trauma who meets all of the following criteria can have their c spine cleared clinically without imaging:

1. No midline tenderness.
2. No pain with neck movement.
3. No distracting injury.
4. No neuro deficit.
5. No alcohol or drugs.
6. No altered mental status.

What does a cervical MRI rule out?

MRI can detect a variety of conditions of the cervical spine as well as problems in the soft tissues within the spinal column, such as the spinal cord, nerves, and disks. This test is used to evaluate injuries of the seven cervical spine bones or spinal cord.

When can you take off C collar?

The C collar can be removed in the unconscious or obtunded patients once the following criteria have been met: The attending radiologist has dictated a final report of the CT scan of the cervical spine. This final report has no cervical spine fracture or acute abnormality.

Can paramedics clear c-spine?

During the training period, paramedics will not actually clear the c-spine. During the ‘run-in’ and ‘evaluation’ periods, the paramedics will then be empowered by medical directive from the EMS medical directors and the Ministry of Health to “clear” the c-spine of patients according to the CCR.

When should you suspect C-spine injury?

Spinal cord injury should be suspected in unconscious patients, or in patients with axial neck pain or those with evidence of neurological injury. Beware that absence of neurologic findings does not eliminate the possibility of spinal cord injury. Physical examination should include a detailed neurological examination.

Can an EMT clear c-spine?

No decision‐making tool has yet been validated for the clearance of c‐spine after injury in prehospital care. Such tools have, however, been validated in the hospital environment with some evidence to support clearance of c‐spine by nurses in the ED.

When to get a clearance for the C spine?

Obtain an MRI of the C-spine. If both are negative and have been read by the attending radiologist, the C-spine may be cleared. Appropriate documentation should appear in the chart. If CT or MRI show bony or ligamentous abnormalities or instability, then consult orthopedic or neurosurgical spine service.

When to have a MRI of the cervical spine?

Radiography of the cervical spine is usually the first diagnostic test ordered in patients who present with neck and limb symptoms More often than not, this study is diagnostic of cervical disc disease as the cause of the radiculopathy

How long does it take to clear a cervical spine?

If the radiologic evaluation is negative per the attending radiologist and the patient still has no pain, the C-spine can be cleared after a note is written in the chart. The goal is to clear the C-spine within four hours. If there is a significant painful “distracting” injury, then the goal is to clear the C-spine in less than 12 hours.

What is the trauma guideline for cervical spine?

TRAUMA GUIDELINE: Injury to the cervical spine is a common occurrence in the polytrauma patient. It is imperative that the diagnosis be made as early as possible after arrival to the hospital. Several factors must be considered during the evaluation of these patients such as mechanism of injury, appropriate physical exam, and imaging.