Variability of prehospital spinal immobilization in children at risk for cervical spine injury

Emily G. Kim, Kathleen M. Brown, Julie C. Leonard, David M. Jaffe, Cody S. Olsen, Nathan Kuppermann

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

OBJECTIVE: This study aimed to compare prehospital spinal immobilization techniques applied to age-based cohorts of children with and without cervical spine injury (CSI) after blunt trauma. METHODS: We compared prehospital spinal immobilization in 3 age-based cohorts of children with blunt trauma-related CSI transported to 1 of 17 participating hospitals. We also compared children younger than 2 years with CSI with those at risk for but without CSI after blunt trauma. We identified patients through query of billing and radiology databases. We compared immobilization methods using Fisher's exact test for homogeneity. RESULTS: We identified 16 children younger than 2 years, 78 children 2 to 7 years old, and 221 children 8 to 15 years old with CSI, and 66 children younger than 2 years without CSI. There were no significant differences in spinal immobilization techniques applied to children younger than 2 years old with and without CSI (P = 0.34). Of the 82 children younger than 2 years, 34 (41%) were fully immobilized in a cervical collar and rigid long board. There was a significant difference between spinal immobilization techniques applied to children with CSI younger than 2 years and 8 to 15 years old (P < 0.01). Six (38%) children with CSI younger than 2 years were fully immobilized versus 49 (63%) children 2 to 7 years old and 175 (79%) children 8 to 15 years old. CONCLUSIONS: In this retrospective, observational study involving several emergency departments and Emergency Medical Services systems, we found that full spinal immobilization is inconsistently applied to children younger than 2 years after blunt trauma regardless of the presence of CSI. Full spinal immobilization is applied more consistently to older children with CSI.

Original languageEnglish (US)
Pages (from-to)413-418
Number of pages6
JournalPediatric Emergency Care
Volume29
Issue number4
DOIs
StatePublished - Apr 2013

Fingerprint

Immobilization
Spine
Wounds and Injuries
Nonpenetrating Wounds
Emergency Medical Services
Radiology
Observational Studies
Hospital Emergency Service
Retrospective Studies

Keywords

  • injury
  • spinal cord
  • trauma

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine

Cite this

Variability of prehospital spinal immobilization in children at risk for cervical spine injury. / Kim, Emily G.; Brown, Kathleen M.; Leonard, Julie C.; Jaffe, David M.; Olsen, Cody S.; Kuppermann, Nathan.

In: Pediatric Emergency Care, Vol. 29, No. 4, 04.2013, p. 413-418.

Research output: Contribution to journalArticle

Kim, Emily G. ; Brown, Kathleen M. ; Leonard, Julie C. ; Jaffe, David M. ; Olsen, Cody S. ; Kuppermann, Nathan. / Variability of prehospital spinal immobilization in children at risk for cervical spine injury. In: Pediatric Emergency Care. 2013 ; Vol. 29, No. 4. pp. 413-418.
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