Information
- Cervical spine should not be cleared without imaging if any of the following National Emergency X-radiography Utilization Study (NEXUS) criteria are present:
- Posterior midline cervical tenderness
- Neurologic deficit
- Painful distracting injuries (that hinder the reliability of questioning and examination)
- Altered level of alertness
- Evidence of intoxication
- In cases where cervical spine imaging is needed, CT scanning has replaced conventional radiography. MRI may be necessary to rule out disc herniation, epidural hematoma, spinal cord compression, and ligamentous injuries (see Chapter 9).
- Anteroposterior (AP) chest is required.
- AP pelvis when the mechanism of injury suggests
- CT scanning of these various regions is used as an adjunct to the primary survey.
- FAST (ultrasound of abdomen) screen for intra-abdominal blood has replaced diagnostic peritoneal lavage when available.