Evaluation of Distracting Pain and Clinical Judgment in Cervical Spine Clearance of Trauma Patients

Kamenetsky, Eric; Esposito, Thomas J.; Schermer, Carol R.

doi:10.1007/s00268-012-1776-9

Cited by 8 publications

(3 citation statements)

References 54 publications

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“…They are similar to the values obtained in this study, which is an approval for the sensitivity range in these guidelines. Additionally, in a study conducted by Hoffman et al, a sensitivity of 99.6% was suggested for NEXUS guidelines, which is consistent with the results of our study and confirms the present findings [ 2 , 23 ].…”

Section: Discussionsupporting

confidence: 93%

“…Trauma cases are definitively the most common cause of hospital emergency department visits. Blunt trauma is among the most dangerous types of trauma due to the likelihood of damage in various organs, such as the neck and spinal cord [ 1 , 2 ]. According to statistical analysis, 13 million trauma patients are treated annually with the possibility of cervical spinal cord injury in the United States and Canada [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

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National emergency X-radiography utilization study guidelines versus Canadian C-Spine guidelines on trauma patients, a prospective analytical study

et al. 2018

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IntroductionThe most common cause of hospital emergency department visits is trauma resulting from a variety of underlying mechanisms. Unknown neck and spinal cord injuries and a lack of early diagnosis can have catastrophic consequences, such as paralysis of some or all limbs. The use of imaging techniques reduces the number of patients suffering from severe injuries.ObjectiveTo assess and compare the effectiveness and ease of utilizing two different sets of guidelines, the National Emergency X-Radiography Utilization Study guidelines (NEXUS) and the Canadian C-Spine guidelines (CCR), on trauma patients.MethodsThis study was approved by the Ethics Committee of Tabriz University of Medical Sciences. Of all the patients presenting to the hospital, 200 trauma patients were randomly included in the study. NEXUS and CCR were surveyed for each patient, and subsequent radiographies were also requested. The specificity and sensitivity of each of the methods was calculated, and the two methods were compared using Kendall’s W test.ResultsA total of 200 trauma patients who met the inclusion criteria were included in the study. A total of 69.5% of the patients were male, and 30.5% were female. According to NEXUS guidelines, 47.5% of the patients were required to undergo neck radiography. According to CCR guidelines, 57.5% of the patients were required to undergo neck radiography. The sensitivity was found to be 90% for neck radiography by both NEXUS and CCR guidelines, while specificities were found to be 54.73% and 44.2% for NEXUS and CCR guidelines, respectively.ConclusionThis study showed that the two guidelines have the same sensitivity for evaluating which trauma patients need to undergo radiography. It seems that the NEXUS guidelines have the same effectiveness as CCR for determining which trauma patients need to undergo radiography. They also perform better than CCR guidelines in terms of ruling out which cases need no further radiologic investigation.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

National emergency X-radiography utilization study guidelines versus Canadian C-Spine guidelines on trauma patients, a prospective analytical study

et al. 2018

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“…43,197 Radiological investigations are often deemed unnecessary for conscious patients without symptoms, neurological deficits, or distracting injuries and that have a full range of motion upon functional examination. 205 Evidence also suggests that this straightforward clearance approach can be simplified even further by ignoring distracting injuries, 206,207 perhaps except for injuries in the upper chest region. 208 Altogether, there is a wide range of algorithms based on different clinical criteria for clearance of the cervical spine in the prehospital setting.…”

mentioning

confidence: 99%

Prehospital Use of Cervical Collars in Trauma Patients: A Critical Review

Sundstrøm

Asbjørnsen

Habiba

et al. 2014

Journal of Neurotrauma

148

115

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The cervical collar has been routinely used for trauma patients for more than 30 years and is a hallmark of state-of-the-art prehospital trauma care. However, the existing evidence for this practice is limited: Randomized, controlled trials are largely missing, and there are uncertain effects on mortality, neurological injury, and spinal stability. Even more concerning, there is a growing body of evidence and opinion against the use of collars. It has been argued that collars cause more harm than good, and that we should simply stop using them. In this critical review, we discuss the pros and cons of collar use in trauma patients and reflect on how we can move our clinical practice forward. Conclusively, we propose a safe, effective strategy for prehospital spinal immobilization that does not include routine use of collars.

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Evaluation and treatment of trauma related collapse in athletes

Gammons

2014

Curr Rev Musculoskelet Med

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Although blunt traumatic injuries are common in athletes, life-threatening trauma is fortunately rare. Most current literature has focused on nontraumatic causes of athlete death though traumatic injuries may be more common. Although prevention of these injuries may be more difficult than nontraumatic causes, prompt recognition and treatment is paramount. Common traumatic causes of collapse athlete generally involve the head, neck, and trunk and are more frequent in collision sports. Other higher risk sports include track and field, cheerleading, snow sports, and those involving motorized vehicles. Health care providers who participate in sports coverage should be aware of the potential for these injuries as emergency treatment is required to maximize outcomes. Emergency action plans allow providers to expediently activate emergency management services while providing treatment and stabilization.

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Evaluation of Distracting Pain and Clinical Judgment in Cervical Spine Clearance of Trauma Patients

Cited by 8 publications

References 54 publications

National emergency X-radiography utilization study guidelines versus Canadian C-Spine guidelines on trauma patients, a prospective analytical study

National emergency X-radiography utilization study guidelines versus Canadian C-Spine guidelines on trauma patients, a prospective analytical study

Prehospital Use of Cervical Collars in Trauma Patients: A Critical Review

Evaluation and treatment of trauma related collapse in athletes

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