A 40 yo lady arrives in ED by ambulance with neck and spinal immobilization because she fell down a staircare.
The patient’s vital signs are within normal physiological parameters, she is alert, no deficit, remembers all, denies head contusion and neck pain. She complains for a sharp shoulder pain (NRS 10/10), it seems broken.
If I perform the Nexus C-Spine criteria X Ray is indicated: a distracting injury mandates cervical spine imaging.
How much the presence of distracting injury reduces my sensibility in rule out cervical spine (c-spine) injury?
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