NEXUS criteria

Dr Craig Hacking and Dr Matt A. Morgan et al.

NEXUS (National Emergency X-Radiography Utilization Study) is a set of validated criteria used to decide which trauma patients do not require cervical spine imaging.

Trauma patients who do not require cervical spine imaging require all of the following:

  • alert and stable
  • no focal neurologic deficit
  • no altered level of consciousness
  • not intoxicated
  • no midline spinal tenderness
  • no distracting injury

The NEXUS criteria have a sensitivity of 99.6% for ruling out cervical spine injury in the original study validating the criteria (95% confidence interval, 98.6-100%) 2.

The NEXUS criteria may not be reliable with patient >65 years of age, however 4.

See also

There is debate over whether the NEXUS criteria or the Canadian c-spine rules are more reliable for excluding c-spine injury 3.

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rID: 54089
Section: Approach
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