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Canadian C-Spine Rule

Records the Canadian C-Spine Rule sequence in the documented population. The tool does not instruct cervical movements; rotation not yet assessed gives an incomplete result.

Calculate with transparency

Check the population, units and version. The result shows the formula or classification; it does not make an automatic treatment decision.

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Method · Limits of application

Stiell 2001; Canadian C-Spine Rule

Does not instruct cervical movements. Unassessed rotation produces an incomplete result. An absent criterion does not mean an injury is absent.

Required fields: 0/10 completed

Complete all required fields. Optional fields are marked.

Exclusion criterion: age < 16 years, Glasgow < 15, abnormal vital signs, trauma more than 48 h ago, penetrating trauma, acute paralysis, known vertebral disease/prior cervical surgery, reassessment of the same injury or pregnancy required

High risk: age ≥ 65 years required

High risk: dangerous mechanism (fall ≥ 0.9 m or 5 steps, axial load to the head, high-speed collision, rollover or ejection, motorized recreational vehicle, bicycle collision) required

High risk: paresthesias in the extremities required

Low risk: simple rear-end collision (no vehicle pushed into oncoming traffic, impact by a bus/large truck, rollover or high-speed impact) required

Low risk: sitting in the emergency department required

Low risk: walked at any time after the trauma required

Low risk: delayed onset of neck pain required

Low risk: no midline cervical tenderness required

Can actively rotate the neck 45° to the right and left? (optional)

Blunt trauma ≤ 48 h ago; age ≥ 16 years, Glasgow 15, normal vital signs and inclusion by neck pain or injury above the clavicles + inability to walk + dangerous mechanism confirmed? required

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Conditions of use

Check the conditions of application before calculating. The result presents the documented formula or criteria; it does not establish a diagnosis or prescription.

Scope of this implementation

Does not instruct cervical movements. Unassessed rotation produces an incomplete result. An absent criterion does not mean an injury is absent.

Parameters in this edition

Exclusion criterion: age < 16 years, Glasgow < 15, abnormal vital signs, trauma more than 48 h ago, penetrating trauma, acute paralysis, known vertebral disease/prior cervical surgery, reassessment of the same injury or pregnancy
High risk: age ≥ 65 years
High risk: dangerous mechanism (fall ≥ 0.9 m or 5 steps, axial load to the head, high-speed collision, rollover or ejection, motorized recreational vehicle, bicycle collision)
High risk: paresthesias in the extremities
Low risk: simple rear-end collision (no vehicle pushed into oncoming traffic, impact by a bus/large truck, rollover or high-speed impact)
Low risk: sitting in the emergency department
Low risk: walked at any time after the trauma
Low risk: delayed onset of neck pain
Low risk: no midline cervical tenderness
Can actively rotate the neck 45° to the right and left?
Blunt trauma ≤ 48 h ago; age ≥ 16 years, Glasgow 15, normal vital signs and inclusion by neck pain or injury above the clavicles + inability to walk + dangerous mechanism confirmed?

Sources and documentation

Method version

Stiell 2001; Canadian C-Spine Rule

Formula and criteria

Sequence: exclusions → high-risk factors → presence of a low-risk factor → active rotation already clinically assessed.

Population and limitations

Does not instruct cervical movements. Unassessed rotation produces an incomplete result. An absent criterion does not mean an injury is absent.

Synthetic cases checked (6)

Synthetic cases for checking the implementation, with no patient data.

Case 1

reference-001

Inputs

Exclusion criterion: age < 16 years, Glasgow < 15, abnormal vital signs, trauma more than 48 h ago, penetrating trauma, acute paralysis, known vertebral disease/prior cervical surgery, reassessment of the same injury or pregnancy: No
High risk: age ≥ 65 years: No
High risk: dangerous mechanism (fall ≥ 0.9 m or 5 steps, axial load to the head, high-speed collision, rollover or ejection, motorized recreational vehicle, bicycle collision): No
High risk: paresthesias in the extremities: No
Low risk: simple rear-end collision (no vehicle pushed into oncoming traffic, impact by a bus/large truck, rollover or high-speed impact): No
Low risk: sitting in the emergency department: Yes
Low risk: walked at any time after the trauma: No
Low risk: delayed onset of neck pain: No
Low risk: no midline cervical tenderness: No
Can actively rotate the neck 45° to the right and left?: Yes
Blunt trauma ≤ 48 h ago; age ≥ 16 years, Glasgow 15, normal vital signs and inclusion by neck pain or injury above the clavicles + inability to walk + dangerous mechanism confirmed?: Yes

{
  "excl": false,
  "idade65": false,
  "mecanismo": false,
  "parestesia": false,
  "colisao": false,
  "sentado": true,
  "deambulou": false,
  "tardia": false,
  "semdor": false,
  "rot": "1",
  "contexto": "1"
}

Expected result

{
  "img": 0,
  "step": 3,
  "incomplete": false
}

Actual result

{
  "img": 0,
  "step": 3,
  "incomplete": false
}

Case 2

reference-002

Inputs

Exclusion criterion: age < 16 years, Glasgow < 15, abnormal vital signs, trauma more than 48 h ago, penetrating trauma, acute paralysis, known vertebral disease/prior cervical surgery, reassessment of the same injury or pregnancy: No
High risk: age ≥ 65 years: Yes
High risk: dangerous mechanism (fall ≥ 0.9 m or 5 steps, axial load to the head, high-speed collision, rollover or ejection, motorized recreational vehicle, bicycle collision): No
High risk: paresthesias in the extremities: No
Low risk: simple rear-end collision (no vehicle pushed into oncoming traffic, impact by a bus/large truck, rollover or high-speed impact): No
Low risk: sitting in the emergency department: Yes
Low risk: walked at any time after the trauma: No
Low risk: delayed onset of neck pain: No
Low risk: no midline cervical tenderness: No
Can actively rotate the neck 45° to the right and left?: null
Blunt trauma ≤ 48 h ago; age ≥ 16 years, Glasgow 15, normal vital signs and inclusion by neck pain or injury above the clavicles + inability to walk + dangerous mechanism confirmed?: Yes

{
  "excl": false,
  "idade65": true,
  "mecanismo": false,
  "parestesia": false,
  "colisao": false,
  "sentado": true,
  "deambulou": false,
  "tardia": false,
  "semdor": false,
  "rot": null,
  "contexto": "1"
}

Expected result

{
  "img": 1,
  "step": 1,
  "incomplete": false
}

Actual result

{
  "img": 1,
  "step": 1,
  "incomplete": false
}

Case 3

reference-003

Inputs

Exclusion criterion: age < 16 years, Glasgow < 15, abnormal vital signs, trauma more than 48 h ago, penetrating trauma, acute paralysis, known vertebral disease/prior cervical surgery, reassessment of the same injury or pregnancy: No
High risk: age ≥ 65 years: No
High risk: dangerous mechanism (fall ≥ 0.9 m or 5 steps, axial load to the head, high-speed collision, rollover or ejection, motorized recreational vehicle, bicycle collision): No
High risk: paresthesias in the extremities: No
Low risk: simple rear-end collision (no vehicle pushed into oncoming traffic, impact by a bus/large truck, rollover or high-speed impact): No
Low risk: sitting in the emergency department: No
Low risk: walked at any time after the trauma: No
Low risk: delayed onset of neck pain: No
Low risk: no midline cervical tenderness: No
Can actively rotate the neck 45° to the right and left?: Yes
Blunt trauma ≤ 48 h ago; age ≥ 16 years, Glasgow 15, normal vital signs and inclusion by neck pain or injury above the clavicles + inability to walk + dangerous mechanism confirmed?: Yes

{
  "excl": false,
  "idade65": false,
  "mecanismo": false,
  "parestesia": false,
  "colisao": false,
  "sentado": false,
  "deambulou": false,
  "tardia": false,
  "semdor": false,
  "rot": "1",
  "contexto": "1"
}

Expected result

{
  "img": 1,
  "step": 2,
  "incomplete": false
}

Actual result

{
  "img": 1,
  "step": 2,
  "incomplete": false
}

Case 4

reference-004

Inputs

Exclusion criterion: age < 16 years, Glasgow < 15, abnormal vital signs, trauma more than 48 h ago, penetrating trauma, acute paralysis, known vertebral disease/prior cervical surgery, reassessment of the same injury or pregnancy: No
High risk: age ≥ 65 years: No
High risk: dangerous mechanism (fall ≥ 0.9 m or 5 steps, axial load to the head, high-speed collision, rollover or ejection, motorized recreational vehicle, bicycle collision): No
High risk: paresthesias in the extremities: No
Low risk: simple rear-end collision (no vehicle pushed into oncoming traffic, impact by a bus/large truck, rollover or high-speed impact): No
Low risk: sitting in the emergency department: Yes
Low risk: walked at any time after the trauma: No
Low risk: delayed onset of neck pain: No
Low risk: no midline cervical tenderness: No
Can actively rotate the neck 45° to the right and left?: No
Blunt trauma ≤ 48 h ago; age ≥ 16 years, Glasgow 15, normal vital signs and inclusion by neck pain or injury above the clavicles + inability to walk + dangerous mechanism confirmed?: Yes

{
  "excl": false,
  "idade65": false,
  "mecanismo": false,
  "parestesia": false,
  "colisao": false,
  "sentado": true,
  "deambulou": false,
  "tardia": false,
  "semdor": false,
  "rot": "0",
  "contexto": "1"
}

Expected result

{
  "img": 1,
  "step": 3,
  "incomplete": false
}

Actual result

{
  "img": 1,
  "step": 3,
  "incomplete": false
}

Case 5

reference-005

Inputs

Exclusion criterion: age < 16 years, Glasgow < 15, abnormal vital signs, trauma more than 48 h ago, penetrating trauma, acute paralysis, known vertebral disease/prior cervical surgery, reassessment of the same injury or pregnancy: No
High risk: age ≥ 65 years: No
High risk: dangerous mechanism (fall ≥ 0.9 m or 5 steps, axial load to the head, high-speed collision, rollover or ejection, motorized recreational vehicle, bicycle collision): No
High risk: paresthesias in the extremities: No
Low risk: simple rear-end collision (no vehicle pushed into oncoming traffic, impact by a bus/large truck, rollover or high-speed impact): No
Low risk: sitting in the emergency department: Yes
Low risk: walked at any time after the trauma: No
Low risk: delayed onset of neck pain: No
Low risk: no midline cervical tenderness: No
Can actively rotate the neck 45° to the right and left?: Not yet tested
Blunt trauma ≤ 48 h ago; age ≥ 16 years, Glasgow 15, normal vital signs and inclusion by neck pain or injury above the clavicles + inability to walk + dangerous mechanism confirmed?: Yes

{
  "excl": false,
  "idade65": false,
  "mecanismo": false,
  "parestesia": false,
  "colisao": false,
  "sentado": true,
  "deambulou": false,
  "tardia": false,
  "semdor": false,
  "rot": "na",
  "contexto": "1"
}

Expected result

{
  "img": null,
  "step": 3,
  "incomplete": true
}

Actual result

{
  "img": null,
  "step": 3,
  "incomplete": true
}

Case 6

reference-006

Inputs

Exclusion criterion: age < 16 years, Glasgow < 15, abnormal vital signs, trauma more than 48 h ago, penetrating trauma, acute paralysis, known vertebral disease/prior cervical surgery, reassessment of the same injury or pregnancy: No
High risk: age ≥ 65 years: No
High risk: dangerous mechanism (fall ≥ 0.9 m or 5 steps, axial load to the head, high-speed collision, rollover or ejection, motorized recreational vehicle, bicycle collision): No
High risk: paresthesias in the extremities: No
Low risk: simple rear-end collision (no vehicle pushed into oncoming traffic, impact by a bus/large truck, rollover or high-speed impact): No
Low risk: sitting in the emergency department: Yes
Low risk: walked at any time after the trauma: No
Low risk: delayed onset of neck pain: No
Low risk: no midline cervical tenderness: No
Can actively rotate the neck 45° to the right and left?: null
Blunt trauma ≤ 48 h ago; age ≥ 16 years, Glasgow 15, normal vital signs and inclusion by neck pain or injury above the clavicles + inability to walk + dangerous mechanism confirmed?: Yes

{
  "excl": false,
  "idade65": false,
  "mecanismo": false,
  "parestesia": false,
  "colisao": false,
  "sentado": true,
  "deambulou": false,
  "tardia": false,
  "semdor": false,
  "rot": null,
  "contexto": "1"
}

Expected result

{
  "img": null,
  "step": 3,
  "incomplete": true
}

Actual result

{
  "img": null,
  "step": 3,
  "incomplete": true
}

Source for the active edition

Stiell et al. · Canadian C-Spine Rule · complete 2001 article and criteria

Additional reading and history

Identifier: canadian-c-spine-rule

Original clinical content: Brazilian Portuguese.

Code and reproducibility

This tool’s code on GitHub

Download code and tests

Sources, version and reproduction instructions

README

Local installation

Code license: Apache-2.0

Guidelines and conditions

This repository’s license applies to the code. Third-party instruments, questionnaires, data and models remain subject to their owners’ conditions.

The code tests are technical checks. Clinical approval and professional translation review are recorded separately.

Relationship with cancer research

General context — relationship to be defined

A resource for general clinical contexts. This edition does not assign a specific oncological relationship; selecting it for a study requires a justified question, population and purpose.