Johnson et al. (2016) state that the guidelines set out in the NEXUS criteria and The Canadian C-spine Rule do not always fit into a prehospital context. As a result of this ambulance services created their own guidelines to follow based upon the Canadian C-Spine Rule and the NEXUS criteria. An example of these is the cervical spine immobilisation procedure from Wellington Free Ambulance. This set of guidelines is based off the NEXUS criteria with influences from the Canadian C-spine rule and are used to determine whether a cervical collar should be placed. The guidelines require gaining a history of the event from the patient, asking about any neck pain or tingling anywhere, checking for midline cervical tenderness via palpation then assessing
