Adapted Canadian C‑Spine rules for managing neck injuries in conscious, stable pre-hospital patients

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This interventional study trains firefighters and EMS physicians in France to apply Canadian C‑Spine rules adapted to the pre-hospital context when attending conscious, stable adults after recent closed cervical trauma. After the rules are applied by the trained responder, an EMS investigating physician makes the final decision about cervical immobilisation in collaboration with that responder. The study will track rates of collar use, imaging, emergency department referrals, and detection of clinically important cervical spine injuries to compare care pathways before and after CCRa implementation. The goal is to determine whether implementing CCRa in pre-hospital care can safely streamline patient management and reduce unnecessary resource use.

Why it matters

Who can join: the full rules

Inclusion Criteria:

PATIENTS

* GCS 15
* Stable (no organ failure, SBP ≥ 90 mmHg, DBP ≥ 65 mmHg, RF between 10 and 24 cycles/min)
* Cooperative (calm and obedient to instructions)
* Victim of a closed cervical spine trauma treated in the pre-hospital setting (fire brigade and/or Mobile Emergency and Resuscitation Service (SMUR)).
* Recent trauma (\< 48 hours).
* Care regulated by the Emergency Medical Service (SAMU).
* Beneficiary of a social security scheme.
* Who can be contacted by telephone
* Have received oral and written information and have not objected to taking part in the study.

PROFESSIONAL

* Age ≥ 18 years
* Professional firefighter or EMS regulating doctor
* Professional who has received training in the protocol and, in the case of the experimental group, in the CCRa rules
* Fluency in French
* Having received oral and written information and not having objected to their participation in the study.

Exclusion Criteria:

PATIENTS

* Life-threatening organ damage
* Cardiorespiratory arrest since the traumatic event in question
* Polytrauma patient
* Penetrating trauma or a supra-clavicular wound following a knife or firearm injury
* Known spinal disease or previous spinal surgery (ankylosing spondylitis, rheumatic fever, spinal stenosis, cervical spine surgery).
* Acute paralysis (paraplegia, tetraplegia, hemiplegia, hemiparesis or documented sensory or motor deficit)
* Diagnosed osteogenesis imperfecta.
* Patients not regulated by EMS or transported to a hospital not participating in the study
* Pregnant or breast-feeding women
* Known situation of deprivation of liberty (safeguard of justice), guardianship or curatorship

PROFESSIONALS

\- Persons referred to in articles L. 1121-5 to L. 1121-8 and L. 1122-1-2 of the Public Health Code (e.g. minors, protected adults, persons deprived of their liberty, persons under guardianship, curatorship, etc.).

Where it's running

• CHU Nantes
  Nantes, France Recruiting
• CHU Rennes
  Rennes, France Recruiting
• CHU Amiens-Picardie
  Amiens, France Not yet recruiting
• CHRU Besançon
  Besançon, France Not yet recruiting
• Centre Hospitalier Sud-Francilien
  Corbeil-Essonnes, France Not yet recruiting
• CHU Grenoble
  Grenoble, France Not yet recruiting

Study contacts

• Principal investigator: François Saget, Md — CHU Rennes / Rennes University Hospital
• Study coordinator: Marie-Laure Gervais, PhD
• Email: marie-laure.gervais@chu-rennes.fr
• Phone: 2 99 28 25 91

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.