Pragmatic Strategy Empowering Paramedics to Assess Low-Risk Trauma Patients With the Canadian C-Spine Rule and Selectively Transport Them Without Immobilization: Protocol for a Stepped-Wedge Cluster Randomized Trial

Christian Vaillancourt   ^{1, 2 *} , MD, MSc ;   Manya Charette   ^{2 *} , MSc ;   Monica Taljaard   ² , PhD ;   Kednapa Thavorn   ² , BPharm, MPharm, PhD ;   Elizabeth Hall   ³ , BSc ;   Brent McLeod   ⁴ , MPH/MHM, ACP ;   Dean Fergusson   ² , MHA, PhD ;   Jamie Brehaut   ² , PhD ;   Ian Graham   ² , MA, PhD, FCAHS ;   Lisa Calder   ⁵ , MD, MSc ;   Tim Ramsay   ² , PhD ;   Peter Tugwell   ² , O.C., MD ;   Peter Kelly   ⁶ , ACP ;   Sheldon Cheskes   ⁷ , MD ;   Refik Saskin   ⁸ , MSc ;   Amy Plint   ⁹ , MD, MSc ;   Martin Osmond   ⁹ , MD ;   Colin Macarthur   ¹⁰ , MBChB, PhD ;   Sharon Straus   ¹¹ , MD, MSc ;   Paula Rochon   ¹² , MD, MPH ;   Denis Prud'homme   ¹³ , MD, MSc ;   Simone Dahrouge   ¹⁴ , PhD ;   Susan Marlin   ¹⁵ , MSc ;   Ian G Stiell   ^{1, 2} , MD, MSc

¹ Department of Emergency Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada

² Ottawa Hospital Research Institute, Ottawa, ON, Canada

³ Patient Representative, Owner-Hall Consulting, Director-Helping Hands for India, Kanata, ON, Canada

⁴ Paramedic Representative, Hamilton Paramedic Service, Hamilton, ON, Canada

⁵ Medical Care Analytics, Canadian Medical Protective Association, Ottawa, ON, Canada

⁶ Ottawa Paramedic Service, Ottawa, ON, Canada

⁷ Department of Family and Community Medicine, Division of Emergency Medicine, University of Toronto, Toronto, ON, Canada

⁸ Institute for Clinical Evaluative Sciences, Toronto, ON, Canada

⁹ Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada

¹⁰ Clinical Research Services, SickKids, Toronto, ON, Canada

¹¹ Knowledge Translation Program, St. Michael’s Hospital, Toronto, ON, Canada

¹² Women’s College Research Institute, Toronto, ON, Canada

¹³ Institut de recherche de l’Hôpital Montfort, Ottawa, ON, Canada

¹⁴ Élisabeth Bruyère Research Institute, Ottawa, ON, Canada

¹⁵ Clinical Trials Ontario, Toronto, ON, Canada

*these authors contributed equally