Using cervical spine clearance guidelines in a pediatric population: A survey of physician practices and opinions

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24 Citations (Scopus)

Abstract

Background: Unlike in adults, there are currently no standardized, validated guidelines to aid practitioners in clearing the pediatric cervical spine (C-spine). Many pediatric centres in Canada have locally produced, adult-modified guidelines, but theextenttowhichtheseorotherguidelinesareusedisunknown. Objective: The purpose of this study was to determine if Canadian physicians are using either locally produced or adult C-spine guidelines to clear the C- spines of patients, 16 years of age. The study also characterized the common methods used by physicians to clear pediatric C-spine injuries in terms of clinical examination and radiologic imaging. Methods: A 20-question survey was distributed to 240 Canadian pediatric emergency physicians and trauma team leaders using the Dillman Total Design Method. Results: The response rate was 68%. The results showed that 61% of physicians currently use guidelines to assist in the clearance of pediatric C-spines. Of those physicians not using guidelines, 85% stated that they would use them if they were available. The clinical criteria most often used to clear pediatric C-spines were a normal neurologic examination (97%) and the absence of C-spine tenderness (95%), intoxication (94%), and distracting injuries (87%). Conclusions: Guidelines are commonly used by Canadian physicians when clearing the pediatric C-spine, yet few are validated in children. Those most commonly used are locally developed guidelines, the Canadian C-spine guidelines, or National Emergency X-Radiography Utilization Study (NEXUS) low-risk criteria.

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalCanadian Journal of Emergency Medicine
Volume13
Issue number1
DOIs
Publication statusPublished - Jan 2011
Externally publishedYes

ASJC Scopus Subject Areas

  • Emergency Medicine

PubMed: MeSH publication types

  • Journal Article
  • Practice Guideline
  • Research Support, Non-U.S. Gov't

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