Which of the following is included in the NEXUS criteria for spinal immobilization?

Which of the following is included in the NEXUS criteria for spinal immobilization?

• A. Midline cervical spinal tenderness
• B. Carotid pulse
• C. Blood pressure
• D. Breath sounds

Answer: (A)

NEXUS criteria guide whether a cervical spine injury can be cleared without imaging. One of the criteria is the presence or absence of midline cervical tenderness. If there is no midline cervical tenderness (and the other criteria—alert and oriented, no focal neurological deficit, no intoxication, and no distracting injuries—are also met), the cervical spine can be cleared without radiographs. The reason midline cervical tenderness is included is that its presence raises concern for an underlying cervical injury and thus imaging and continued immobilization are warranted. The other options—carotid pulse, blood pressure, and breath sounds—are not part of the NEXUS criteria and do not determine cervical spine clearance on their own.

NEXUS criteria guide whether a cervical spine injury can be cleared without imaging. One of the criteria is the presence or absence of midline cervical tenderness. If there is no midline cervical tenderness (and the other criteria—alert and oriented, no focal neurological deficit, no intoxication, and no distracting injuries—are also met), the cervical spine can be cleared without radiographs. The reason midline cervical tenderness is included is that its presence raises concern for an underlying cervical injury and thus imaging and continued immobilization are warranted. The other options—carotid pulse, blood pressure, and breath sounds—are not part of the NEXUS criteria and do not determine cervical spine clearance on their own.