This version was machine-translated from German and has not been medically reviewed. The authoritative version is the German version.

PECARN C-Spine Imaging Rule

High- and intermediate-risk factors for cervical spine injury after blunt trauma (Leonard 2024)

High-risk factors

GCS 3–8 or unresponsive (AVPU: U)

abnormal airway, breathing or circulation

focal neurological deficit (paresthesia, numbness, weakness)

Intermediate-risk factors

Neck pain

altered level of consciousness (GCS 9–14, AVPU V or P)

significant head injury

significant torso injury

Tenderness over the midline of the neck

Calculation aid for healthcare professionals: the calculator reproduces what the sources cited assign to the inputs. Clinical assessment and every treatment decision remain with the treating physician. Inputs and results are not stored.

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Sources

Identifying children at very low risk of clinically important blunt abdominal injuries (Ann Emerg Med 62:107–116) Holmes JF, Lillis K, Monroe D, et al.; Pediatric Emergency Care Applied Research Network (PECARN), 2013. Original paper
PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study (Lancet Child Adolesc Health 8:482–490) Leonard JC, Harding M, Cook LJ, et al., 2024. Original paper
Factors associated with cervical spine injury in children after blunt trauma (Ann Emerg Med 58:145–155) Leonard JC, Kuppermann N, Olsen C, et al., 2011. Original paper (8 risk factors)

Scientific basis last reviewed: September 2026.

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Note

Calculation aid for healthcare professionals. Percentiles and z-scores describe the position of a measured value in the reference population; clinical assessment remains with the treating physician.