Evaluation of the Nursing C-Spine (Phase IV)

Inclusion Criteria: The investigators will enroll consecutive alert, stable adults presenting to the study hospital EDs with potential c-spine injury after sustaining acute blunt trauma. These will be patients presenting with neck pain or with c-spine immobilization on an ambulance stretcher. Patient eligibility will be determined based on these criteria at the time of arrival in the ED. * "Potential c-spine injury after sustaining acute blunt trauma" will include patients with either: i) neck pain with any mechanism of injury (subjective complaint by the patient of any pain in the posterior aspect of the neck), and/or ii) presentation by ambulance with c-spine immobilization after injury (typically backboard and collar). * "Alert" is defined as a Glasgow Coma Scale103 score of 15 (converses, fully oriented, and follows commands). * "Stable" refers to normal vital signs as defined by the Revised Trauma Score31 (systolic blood pressure 90 mm Hg or greater and respiratory rate between 10 and 24 breaths per minute). * "Acute" refers to injury within the past 48 hours. Exclusion Criteria: * Patients under the age of 16 years, * Patients who do not satisfy the definition of "potential c-spine injury" as defined above (for example, patients with neither neck pain nor arriving with ambulance c-spine immobilization will be excluded), * Patients with Glasgow Coma Scale score less than 15, * Patients with unstable vital signs (systolic BP \< 90; respiratory rate less than 10 or mor…