Clinical Decision Rule of Inagaki et al for Ordering Cervical CT Scan After Head or Neck Trauma

Patient selection: head or neck trauma

A cervical CT scan should be ordered if:

(1) the Glasgow coma score <= 13

(2) there is posterior cervical tenderness

(3) there is a neurological deficit

(4) trauma was associated with fall down stairs

(5) trauma was associated with fall from height

(6) trauma was associated with a motorcycle accident

If none of the factors are present then a cervical CT scan may not need to be performed.

Performance:

• The sensitivity was 100% and specificity 52% in the study group.

NOTE: There may be need to modify this for certain situations. For example, an INR >= 1.5 is associated with an increased risk for cervical epidural hematoma.