Can ED Triage Nurses Reliably Clear the C-Spine in Minor Trauma?

Stiell, Ian G.; Clement, Catherine M.; O’Connor, Allan; Davies, B.; Leclair, Christine; MacKenzie, Taryn; C, Béland; Peck, Timothy C.; Sheehan, Pamela; Gee, Albert O.; Perry, Jeffrey J.

doi:10.1197/j.aem.2007.03.826

“…19 The rule was prospectively derived (N = 8,924) 20 and validated (N = 8,283) 21 before an implementation trial involving 11,648 patients at 12 hospital EDs. 22 Two further studies have subsequently validated the rule when used by paramedics (N = 3,000) 23 and by nurses (N = 4,000) 24 (Table 3). The objective of the recently completed implementation trial (2003)(2004)(2005) was to evaluate the effectiveness of implementing the Canadian C-Spine Rule in multiple EDs.…”

Section: The Canadian C-spine Rulementioning

confidence: 99%

Implementation of Clinical Decision Rules in the Emergency Department

Stiell

¹

,

Bennett²

2007

Academic Emergency Medicine

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Clinical decision rules (CDRs) are tools designed to help clinicians make bedside diagnostic and therapeutic decisions. The development of a CDR involves three stages: derivation, validation, and implementation. Several criteria need to be considered when designing and evaluating the results of an implementation trial. In this article, the authors review the results of implementation studies evaluating the effect of four CDRs: the Ottawa Ankle Rules, the Ottawa Knee Rule, the Canadian C-Spine Rule, and the Canadian CT Head Rule. Four implementation studies demonstrated that the implementation of CDRs in the emergency department (ED) safely reduced the use of radiography for ankle, knee, and cervical spine injuries. However, a recent trial failed to demonstrate an impact on computed tomography imaging rates. Well-developed and validated CDRs can be successfully implemented into practice, efficiently standardizing ED care. However, further research is needed to identify barriers to implementation in order to achieve improved uptake in the ED.ACADEMIC EMERGENCY MEDICINE 2007; 14:955-959 ª

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Implementation of Clinical Decision Rules in the Emergency Department

Stiell¹,

Bennett²

2007

Academic Emergency Medicine

View full text Add to dashboard Cite

Clinical decision rules (CDRs) are tools designed to help clinicians make bedside diagnostic and therapeutic decisions. The development of a CDR involves three stages: derivation, validation, and implementation. Several criteria need to be considered when designing and evaluating the results of an implementation trial. In this article, the authors review the results of implementation studies evaluating the effect of four CDRs: the Ottawa Ankle Rules, the Ottawa Knee Rule, the Canadian C-Spine Rule, and the Canadian CT Head Rule. Four implementation studies demonstrated that the implementation of CDRs in the emergency department (ED) safely reduced the use of radiography for ankle, knee, and cervical spine injuries. However, a recent trial failed to demonstrate an impact on computed tomography imaging rates. Well-developed and validated CDRs can be successfully implemented into practice, efficiently standardizing ED care. However, further research is needed to identify barriers to implementation in order to achieve improved uptake in the ED.

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`Clearing' the cervical spine in conscious trauma patients

Blackham

¹

,

Benger

²

2009

Trauma

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This is a systematic review of published evidence regarding management of the cervical spine in conscious and co-operative trauma patients. We examine the literature in the following sections: clinical evaluation of the cervical spine; use of plain radiography; use of additional radiographic views; use of computed tomography; use of magnetic resonance imaging. Finally we consider the elderly and paediatric populations, particularly where there are significant differences compared to the general adult population. This paper also reviews the literature regarding non-medical assessment of the cervical spine. We conclude that there are well-validated decision rules available to guide the clinician, and that each imaging strategy has distinct advantages and disadvantages. Familiarity with these issues provides a sound basis for safe and effective decision-making.

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Can ED Triage Nurses Reliably Clear the C-Spine in Minor Trauma?

Cited by 3 publications

References 0 publications

Implementation of Clinical Decision Rules in the Emergency Department

Implementation of Clinical Decision Rules in the Emergency Department

Implementation of Clinical Decision Rules in the Emergency Department

`Clearing' the cervical spine in conscious trauma patients

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