Pediatric cervical spine clinical clearance algorithm*

GCS: Glasgow Coma Scale.
* It is possible to clinically clear children of all ages without radiographs when the history does not identify a predisposition to cervical spine injury and there is a normal neurologic and neck examination. Special attention should be paid to the neurologic exam of the infant and young child. Refer to UpToDate topics on cervical spine injuries in children and adolescents.
¶ Substantial chest, abdomen, or pelvic injuries are life-threatening, require surgery, or warrant inpatient hospitalization.
Δ Refer to graphics and topics on spinal motion restriction (spinal immobilization) and imaging for cervical spine injuries in children and adolescents.