NEXUS vs Canadian C-spine?

Both validated; institutions choose one pathway. This tool implements NEXUS.

NEXUS C-Spine Rule

Medical context

Apply NEXUS low-risk criteria to help decide whether cervical spine imaging is needed after trauma.

Emergency clinicians use this at triage, resuscitation, and disposition to standardize risk communication across shifts.

This page explains the NEXUS formula, how to interpret the output, known limitations, and peer-reviewed references so you can verify results against primary sources and local protocols.

It is grouped under Emergency Medicine because trauma, triage, and acute risk scores used in the ed.

How to use this calculator

Enter the values requested by the NEXUS calculator using the units shown beside each field.
Review the calculated result and read the interpretation section before acting on the output.
Check limitations and references if the result will change management, dosing, or disposition.
Use the related calculators section when you need supporting values (for example electrolytes, weight, or complementary risk scores).

Calculator

Midline cervical tenderness

Evidence of intoxication

Normal level of alertness

Focal neurologic deficit

Painful distracting injury

Result

Low risk

NEXUS low-risk — imaging may be unnecessary

Educational use only. Confirm results with clinical judgment, primary sources, and local protocols. Not a substitute for professional medical advice. Full disclaimer.

Formula

Low risk if no midline tenderness, no intoxication, normal alertness, no focal neuro deficit, and no distracting injury.

Interpretation

If all low-risk criteria met, imaging may be unnecessary; otherwise consider imaging pathways.

Limitations

Canadian C-spine rules differ. Use judgment with extremes of age and unreliable exams.

Frequently asked questions

NEXUS vs Canadian C-spine?: Both validated; institutions choose one pathway. This tool implements NEXUS.
Is the NEXUS result enough to make a treatment decision?: No. Calculators support medical decision-making but do not replace examination, shared decision-making, institutional protocols, or consultant input when stakes are high.
Does Calcmedical store the values I type in?: Inputs are processed in your browser for this session. We do not ask for patient names or medical record numbers. See our privacy policy for hosting and analytics details.

References

Hoffman JR et al. NEXUS. NEJM.