Canadian C-Spine Rule (modified for clarity)

Tiny Tip | Canadian C-spine Rule Mnemonic

In Tiny Tips by Teresa Chan4 Comments

Clinical Decision Tool uptake

In 2007, Dr. Ian Stiell wrote a paper [1] about the uptake and real-life implementation of his four clinical decision rules (or as we prefer to call them, clinical decision tools).  The paper concludes that “Future research should identify implementation barriers and explore strategies to achieve better knowledge uptake in the ED”.

The BoringEM team hypothesizes that the ease of use may be greatly affected by the complexity of a rule itself – i.e. if the tool itself is complex and unwieldy, it may not be readily taken up.  For many people, this has lead to barriers for adoption of the Canadian C-Spine Rules.  Especially when compared to the simpler NEXUS spine rule, this CDR often has been noted by various people to be difficult to actually navigate.  Even though, NEXUS has been shown to be less sensitive than the CCR.

A new mnemonic

To alleviate this, we have previously presented a diagram to help with this, but recently a group of McMaster University medical students came up with a nifty new mnemonic to help remember each of the parts of C-spine rule.  With some editorial support by myself, we’ve added it to the diagram from our previous post for clarity.

Canadian C-spine rule mnemonic

By: Sean Robinson, Yuetming Lam, Steffen de Kok

Sixty Five, Fast Drive, Sense Deprive?  Image, if alive.
Slow Wreck, Slow Neck, Sitting down, Walking ’round, C-Spine fine?  Range the spine!
And ultimately….
If you can look both ways, you can cross the road —-> Without Imaging
CCR Mnemonic

Stiell, I. G., & Bennett, C. (2007). Implementation of clinical decision rules in the emergency department. Academic Emergency Medicine, 14(11), 955-959.

Teresa Chan

Senior Editor at CanadiEM
Emergency Physician. Medical Educator. #FOAMed Supporter, Producer and Researcher. Chief Strategy Officer of CanadiEM. Associate Professor, Division of Emergency Medicine, Department of Medicine, McMaster University.
BoringEM has been 'bringing the boring' to emergency medicine since 2012. In 2016 this Canadian blog brought its content to CanadiEM.