Cervical Spine Clearance in the Nonalert, Noncommunicative, or Unreliable Pediatric Blunt Trauma Patient

Abstract

Currently, there is no nationally recognized evidence-based guideline or protocol for cervical spine clearance in nonalert, noncommunicative, or unreliable pediatric blunt trauma patients. This descriptive survey study sought to identify current practices and elicit expert opinion data regarding pediatric cervical spine clearance in a specialized population of children in trauma centers in the United States. A 93-item electronic Pediatric Cervical Spine Clearance Survey was sent to 309 members of the Pediatric Special Interest Group of the National Society of Trauma Nurses. The main areas of interest in the survey included trauma verification, annual volume of pediatric trauma cases, and sequence and time frames of diagnostic testing for cervical spine clearance by age group. Additional areas of interest were perceived supports and barriers to meeting target time frames for diagnostic testing and outcomes to evaluate the impact of a cervical spine clearance guideline for pediatric blunt trauma. The results from 44 respondents demonstrate that trauma centers are using a variety of diagnostic testing sequences and time frames when clearing children for suspected cervical spine injury.