NEXUS Criteira - I need supporting documents for AMS.

AeroClinician

AeroClinician

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I believe most ems providers are aware of the NEXUS criteria. Now looking at the criteria, the presence of an altered mental status -or- inability to communicate -or- intoxication, is listed as indicators for spinal immobilization.

With that said, to my knowledge, I am under the impression that those criteria points that I listed above are reason to immobilize because that the pt. in those conditions, is unable to communicate to you if they are in fact experiencing any spinal pain - or- neurological symptoms. NOT, because the presence of an altered mentation at anytime post incident is reason by itself for immobilization. Example would be a pt. that experienced an altered mental status (according to bystanders) post injury that resolved prior to EMS contact (Ex. Concussion) with A/Ox4 upon EMS contact with no spinal pain -or- neuro symptoms.

Does any one have any references that state that the reason for AMS to be part of the criteria is that because you are unable to accurately determine the presence of spinal pain/neuro symptoms?

Thanks
 
It is my understanding that this is about the patient being able to communicate effectively and the need for the patients sensorium to not be clouded by intoxicants. You may have to go back to the original studies to get an answer.
 
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Here is the NEXUS study, as published in the New England Journal Of Medicine in 2000. It specifically list, "a normal level of alertness" as what is required when it comes to satisfying the patient mentation portion during the implementation of the "Decision Instrument".

http://www.nejm.org/doi/full/10.1056/NEJM200007133430203


Its a really interesting read.
 
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