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this and that

DocRickFry at aol.com DocRickFry at aol.com
Mon Oct 10 10:47:46 BST 2005

In a message dated 10/9/2005 8:27:23 P.M. Eastern Daylight Time,  
sumieb at compuserve.com writes:

So you  have a awake and alert patient, has midline tenderness, no  peripheral
deficits, normal 3 view plain films and normal CT.

Does  that clear the c-spine?  Do you need flexion/extension (passive  or

An awake and alert patient with no neck tenderness clears the c-spine all  by 
itself --no x-rays are necessary and need not be gotten--collar off with that 
 alone.  This is nothing new, friends--again, for the literature on this and  
standard of care (which the above is) see EAST Practice Management Guidelines 
at  _www.east.org_ (http://www.east.org) 
If there is tenderness, CT is close to becoming the standard--if negative,  
collar stays on until neck tenderness resolves.  In other words, the  ultimate 
clearance is NOT x-rays but phys exam

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