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  • Title: Implementation of pediatric cervical spine clearance guidelines at a combined trauma center: Twelve-month impact.
    Author: Rosati SF, Maarouf R, Wolfe L, Parrish D, Poppe M, Manners R, Brown K, Haynes JH.
    Journal: J Trauma Acute Care Surg; 2015 Jun; 78(6):1117-21. PubMed ID: 26151510.
    Abstract:
    BACKGROUND: Pediatric cervical spine clearance guidelines should reduce computed tomography (CT) usage in combined pediatric and adult trauma centers biased by adult CT clearance. METHODS: Cervical spine clearance under age 15 years was compared 12 months before (128 patients) and after (105 patients) guideline implementation, emphasizing National Emergency X-Radiography Utilization Study (NEXUS) criteria when appropriate. RESULTS: CT scans in patients clearable by NEXUS criteria decreased 23% (p = 0.01) and decreased by 16% in cases where radiography other than CT was indicated by guidelines (p = 0.01). CONCLUSION: Guideline implementation can have an immediate effect in decreasing pediatric cervical spine CT usage and should improve across time. LEVEL OF EVIDENCE: Care management study, level IV.
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