Evaluation of the Safety of C-Spine Clearance by Paramedics

Inclusion Criteria: * consecutive alert, stable adults evaluated by the paramedics with potential c-spine injury after sustaining acute blunt trauma. Patient eligibility will be determined at the time of paramedic arrival at the scene based on the following criteria: * "Potential c-spine injury after sustaining acute blunt trauma" will include patients with either: * neck pain with any mechanism of injury (subjective complaint by the patient of any pain in the posterior aspect of the neck), * no neck pain but some visible injury above the clavicles, and/or * neither neck pain nor visible injury, but significant mechanism of injury as determined by the paramedic at the scene. * "Alert" is defined as a Glasgow Coma Scale score of 15 (converses, fully oriented, and follows commands). * "Stable" refers to normal vital signs(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 4 hours. Exclusion Criteria: * Patients under the age of 16 years, * Patients with penetrating trauma from stabbing or gunshot wound, * Patients with acute paralysis (paraplegia, quadriplegia), * Patients with known vertebral disease (ankylosing spondylitis, rheumatoid arthritis, spinal stenosis, or previous cervical spine surgery), or * Patients referred from another hospital and transported between facilities.