Guideline for cervical spine clearance in the reliable pediatric patient

c-spine: cervical spine; AP: antero-posterior; D/C: discontinue; MRI: magnetic resonance imaging; CT: computed tomography.
* Awake and alert with Glasgow Coma Scale (GCS) = 15.
¶ Meets NEXUS criteria (no midline cervical spine tenderness, no focal neurologic deficit, normal alertness, no intoxication, and no painful, distracting injury) AND moves head in flexion/extension AND rotate 45 degrees to both sides with no pain.
Δ Change to long term cervical spine collar as soon as appropriate.