To evaluate neck injuries using the Canadian C-Spine Rule (CCR), the calculator examines specific risk factors and assigns scores to assess whether imaging is required. The assessment focuses on three areas: high-risk factors, low-risk factors, and neck rotation ability. Each is given a numerical score that corresponds to the presence of certain conditions.

First, we look at high-risk factors, which are critical in determining the need for imaging. These include:
- Age 65 years or older
- Paresthesias in extremities
- Dangerous mechanisms of injury such as falls from a height of 1 meter or more, axial load to the head, high-speed motor vehicle collisions, rollovers, ejections, motorized recreational vehicle accidents, or bicycle collisions

Each high-risk factor, if present, contributes a score of 17 to the total.

Next, low-risk factors are evaluated, which may reduce the concern for serious injury. These include:
- Being involved in a simple rear-end motor vehicle collision
- Sitting position in the emergency department
- Being ambulatory at any time
- Experiencing delayed-onset neck pain
- Absence of midline cervical spine tenderness

Each of these low-risk factors adds a score of 1.

Lastly, the ability to rotate the neck by 45 degrees both left and right is considered. The scoring for this is:
- Yes: 5 points
- No: 11 points

Totaling the scores from these inputs helps interpret the risk. Here's how interpretations are derived from the total score:
- A score from 6 to 10 indicates "Low risk. No imaging is required."
- A score of 12 or higher signals "High risk. Imaging is required."
- Specific scores, such as those 5 or lower or precisely 11, suggest that the CCR cannot be fully assessed.

This scoring system ensures those at high risk are identified for imaging, aiding in the management of neck injuries. The resulting score and interpretation guide clinical decisions about the need for imaging.

The Canadian C-Spine Rule (CCR) is a clinical decision-making tool designed for use in the emergency department to determine which patients with trauma need cervical spine imaging. This calculator is specifically applicable to alert and stable patients who have experienced trauma, with the goal of reducing unnecessary imaging procedures. The CCR is not intended for use in patients under the age of 16, those with penetrating trauma, acute paralysis, known vertebral disease, or those with a previous cervical spine surgery. The clinical utility of the CCR lies in its ability to accurately identify patients at high risk of cervical spine injury, thereby improving patient management and reducing healthcare costs.