NEXUS Criteria Calculator

NEXUS Criteria Calculator for Neurology. Five reliably absent findings support clinical clearance in context; they do not guarantee absence of injury. Definitions and the original population are in the primary report: https://www.nejm.org/doi/abs/10.1056/NEJM200007133430203

For shared guidance on choosing a tool and documenting results, read the clinical calculator workflow.

How this calculator works

All five findings must be absent to meet NEXUS low-risk criteria. Presence of any one prevents clinical clearance; no cancellation or weighted sum is used. Original validation: https://pubmed.ncbi.nlm.nih.gov/10891516/

When to use this calculator

Assist cervical-spine injury assessment after blunt trauma. This is not the separate NEXUS Head CT instrument.

Inputs used

  • Blunt-trauma clinical context with reliable examination
  • Posterior midline cervical tenderness
  • Evidence of intoxication
  • Abnormal alertness
  • Focal neurological deficit
  • Painful distracting injury

Clinical interpretation

Five reliably absent findings support clinical clearance in context; they do not guarantee absence of injury. Definitions and the original population are in the primary report: https://www.nejm.org/doi/abs/10.1056/NEJM200007133430203

Worked example

Four findings are absent, but alertness cannot be assessed. The outcome is incomplete, not zero or low risk. If midline tenderness is present instead, low-risk criteria are not met.

Limitations and safety notes

Distracting injury and intoxication require clinical judgment. Children, older people and communication barriers need particular care when judging reliability. This widget neither orders a modality nor overrides persisting clinical concern.

Frequently asked questions

Does a blank checkbox count as absent?

No. Every finding requires an explicit assessment; unknown is retained as uncertainty.

References

  • Hoffman et al. Original NEXUS validation, 2000: https://pubmed.ncbi.nlm.nih.gov/10891516/
  • Original NEJM report, five criteria and study population: https://www.nejm.org/doi/abs/10.1056/NEJM200007133430203

Editorial review and citation methodology

Maintained by the Quick Medical Calculator Editorial Team. Content record date: September 9, 2026. A content date is not evidence of independent clinical review. Individual clinical sign-off is not recorded on this page.

  • Prefer original validation studies for scoring systems and prediction tools.
  • Use current specialty society guidance, transplant allocation policy, public health guidance, or regulator resources when they govern clinical use.
  • Include limitations and safety notes when a calculator is population-specific, context-dependent, or unsuitable as a standalone decision tool.

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