NEXUS C Spine Clearance Rule Calculator

Interpretation and clinical use The NEXUS C Spine Clearance Rule identifies five clinical criteria. If none of the five criteria are present in a patient who is clinically reliable, the likelihood of clinically important cervical spine injury is low and radiographic imaging may be avoided. If any criterion is present imaging is recommended.

Clinical reliability includes normal mental status and absence of significant pain that prevents examination. Use this tool as an aid and not as a substitute for clinical judgment. Consider patient specific factors and institutional protocols when applying the rule.

Reference Hoffman JR and colleagues. Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. Annals of Emergency Medicine.

This publication describes the original NEXUS criteria and their validation in blunt trauma patients.