Girl, I like your flow [chart]

Working with a patient with neck problems?

Get your Canadian Cervical Spine Rules on to determine if you need to send them for an x-ray.


With such a high sensitivity, you can be confident that if they clear the c-spine rules that they don’t require an x-ray. This allows physicians in the emergency department to be more selective about who they send off for radiographs and it allows physical therapists to be confident when treating the spine.

(Remember a tool with high sensitivity identifies those with an impairment, if the sensitivity is high there are few false negatives: So when the rules determine that a patient needs an X-Ray, those x-rays are likely going to show a serious pathology. Consequently, when screening for red flags ideally your tests will have high sensitivity.)

So roll your way through this flow chart anytime you treat a patient with neck problems:

c-spine rules

Citation: Stiell IG, Wells GA, Vandemheen KL. et al. The Canadian C-Spine Rule for radiography in alert and stable trauma patients. JAMA.2001;286:1841-1848.

Totally not related, except that it is my favorite flow-chart of all time:

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