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Pediatric Cervical Spine Clearance Working Group algorithm

Pediatric Cervical Spine Clearance Working Group algorithm

C-spine: cervical spine; CT: computed tomography; GCS: Glasgow Coma Score.

* Stronger consideration for imaging should be given towards patients with the following mechanisms of injury (MOI): diving, axial load, clothes-lining and high-risk MVC (HR-MVC), however the literature findings are controversial. HR-MVC is defined as a head-on collision, rollover, ejected from the vehicle, death in the same crash, or speed >55 mph.

¶ Substantial injury is defined as an observable injury that is life-threatening, warrants surgical intervention, or warrants inpatient observation.

Δ All imaging should be read by an attending physician.

◊ Adequate flexion/extension is defined as ≥30 degrees of flexion and ≥30 degrees of extension.

§ Patient has achieved GSC 14 to 15 and no longer presents with abnormal head posture, persistent neck pain, or difficulty in neck movement.
Reproduced with permission from: Herman MJ, Brown KO, Sponseller PD, et al. Pediatric cervical spine clearance: A consensus statement and algorithm from the Pediatric Cervical Spine Clearance Working Group. J Bone Joint Surg Am 2019; 101(1):e1. Copyright © 2019 The Journal of Bone and Joint Surgery, Inc. https://journals.lww.com/jbjsjournal/pages/default.aspx.
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