title: Adherence to Canadian C-Spine Rule in a regional hospital: a retrospective study of 406 cases.
abstract: BACKGROUND
  Cervical spine radiography may be over-utilised in an emergency department setting. The Canadian C-Spine Rule has been developed to reduce unnecessary radiography. Our aim was to retrospectively determine the proportion of cervical spine radiographs requested through the emergency department for trauma patients that were clinically indicated, according to the Canadian C-Spine Rule.
  
  
  METHODS
  This was a cross-sectional survey conducted at a regional centre in Northern Queensland, Australia. All cervical spine radiographs for trauma, performed at the Mackay Base Hospital from 1 January 2009 to the 31 December 2009, were reviewed. The relevant patient charts were audited for evidence of indications for radiography.
  
  
  RESULTS
  Of 406 patients in the study, 155 patients (38%) (95% confidence interval 33.3%, 42.7%) had cervical spine imaging performed that was not indicated according to the Canadian C-Spine Rule. None of these patients had a significant cervical spine injury on radiography.
  
  
  CONCLUSIONS
  Applying the Canadian C-Spine Rule would have safely reduced the incidence of cervical spine radiography by 38%. This would also reduce costs, patient morbidity and radiation exposure.
authors.affiliation: James Cook University, School of Medicine and Dentistry, Mackay Base Hospital, Mackay, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Paxton
authors.forename: Clare F
authors.initials: CF
authors.lastname: Heal
authors.forename: Herwig
authors.initials: H
authors.lastname: Drobetz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D015995:Prevalence; D011793:Queensland / Q000453:epidemiology; D011859:Radiography / Q000592:standards* / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013124:Spinal Injuries / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D055815:Young Adult