The variability in diagnostic approach and management of c spine injuries has been the impetus for a systematic approach to optimize treatment in pediatric patients with potential or actual cervical spine injuries. In addition, the limited availability of multiple sizes of pediatric extrication collars contributing to poor fit and the prolonged time periods which cervical spine collars are worn prior to clearance contribute to pain, skin breakdown, hygiene issues and other complications for patients. Incomplete ossification of the cervical bones, ligamentous laxity and the vertebral configuration of children contribute to the increased propensity of upper cervical spine injuries and ligamentous and neurologic injury without radiographic abnormalities (SCIWORA) in infants and children. Pediatric patients present developmental and anatomic characteristics which make it difficult to assess their risk of cervical spine injury (CSI). Although, this incidence is low, comparatively speaking, the catastrophic nature of disability which can result necessitates a standardized format for evaluating injuries. It is estimated that 60-80% of these injuries involve the cervical spine. Traumatic spine injuries are reported to occur in 1-3% of pediatric trauma patients presenting for evaluation and treatment to acute care hospitals. The goal is to facilitate prompt and safe cervical spine clearance for the pediatric trauma patient. Purpose: To provide a guideline for clearance of the cervical spine.
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