This Canadian study looked at the safety of paramedics using the modified Canadian C-Spine Rule to determine which pre-hospital blunt trauma patients required immobilization. These were MVC and fall patients predominately. Bottom line: appropriately trained paramedics can use the modified Canadian C-Spine rule to clinically clear cervical spines in the field.
| Result of Application | Paramedics’ Interpretation | Investigators’ Interpretation |
|---|---|---|
| Injury | No Injury | Injury |
| --- | --- | --- |
| Immobilization required (N) | 10 | 1,342 |
| Immobilization not required (N) | 1 | 2,668 |
| Sensitivity, % (95% CI) | 90.9 (58.7–99.8) | 90.9 (58.7 to 99.8) |
| Specificity, % (95% CI) | 66.5 (65.1–68.0) | 68.2 (66.7 to 69.7) |
| Positive likelihood ratio, (95% CI) | 2.7 (2.2–3.4) | 2.9 (2.4 to 3.5) |
| Negative likelihood ratio (95% CI) | 0.1 (0.0–0.9) | 0.1 (0.0–0.9) |
Vaillancourt, Christian et al.
Annals of Emergency Medicine, Volume 81, Issue 2, 187 - 196
