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J Trauma Acute Care Surg ; 78(6): 1117-21, 2015 Jun.
Article in English | MEDLINE | ID: mdl-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.


Subject(s)
Cervical Vertebrae/injuries , Clinical Protocols , Spinal Injuries/diagnostic imaging , Tomography, X-Ray Computed/statistics & numerical data , Trauma Centers , Adolescent , Child , Child, Preschool , Female , Humans , Injury Severity Score , Male , Retrospective Studies , Time Factors
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