NEXUS

Question 1

Adult Cervical SMR Decision Matrix

Answer 1

See “JIBC EMR TT&P” PDF pg. 55

• I unfortunately couldn’t think of an intuitive way to transfer the matrix to flash cards and I’m not going to buy this apps subscription to be able to add pictures to this

Question 2

Modified NEXUS

Answer 2

1. Is there midline tenderness
2. Is there an altered LOC?
   - Must be alert & oriented x4
3. Are there new focal neurological deficits
4. Are they intoxicated
   - Judgement & pain sensation must be intact
5. Is there a major distracting injury
   - Significant enough to interfere with their ability to assess pain response when palpating spine

IF NO TO ALL 5 QUESTIONS - SMR IS NOT WARRANTED

Question 3

Thoracolumbar Injuries

Answer 3

If PT does not require SMR as per NEXUS criteria but has any of the following findings, do NOT sit the PT up or raise the head of the stretcher on the assumption that T/L spine injuries may be present:
- Dangerous MOI
- Fall from height >= 3m
- Axial load to head or base of spine
- High speed MVC (>100kph)
- Rollover MVC
- Pre-existing spinal pathology
- New back deformity, bruising, or bony midline tenderness on logroll