Journal Club: Clinical Prediction Rules

Editor's Capsule Summary for Vaillancourt et al1 What is already known on this topic: Previous out-of-hospital studies indicate that selective spinal immobilization may miss patients with cervical injury. What question this study addressed: Can paramedics apply the Canadian C-Spine Rule in alert, stable, cooperative, blunt-trauma patients to reserve spinal immobilization for high-risk patients while avoiding immobilization for low-risk patients? What this study adds to our knowledge: In this 1,949-patient cohort, paramedics achieved 100% sensitivity and 38% specificity for important cervical fractures. How this might change clinical practice: Use of the Canadian C-spine Rule by paramedics may safely avoid unnecessary spinal immobilization. © 2009.