Incidence of Pediatric Cervical Spine Injuries in Iraq and Afghanistan

Gutierrez, Xandria E; April, Michael D.; Maddry, Joseph K.; Hill, Guyon J.; Becker, Tyson E.; Schauer, Steven G

doi:10.14423/smj.0000000000000974

Cited by 5 publications

(4 citation statements)

References 30 publications

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Section: Resultsmentioning

confidence: 99%

“…Pediatric patients with SCI are currently underserved in their access to cervical collars 49 . In a national study of pediatric trauma encounters in the United States, 83% of pediatric patients with cervical spine fractures did not have a prehospital cervical collar placed 49 . Lack of pediatric‐sized equipment plays a role in the underuse of cervical collars in pediatric patients with potential SCI, 49 necessitating the development of a clinical decision tool to guide cervical collar placement in pediatric patients with SCI or at risk of developing SCI.…”

Section: Resultsmentioning

confidence: 99%

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Cervical collar use in spinal cord injury management

Kolli,

Medina,

DeYoung

et al. 2024

Clinical and Translational Dis

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BackgroundThe use of cervical collars in the management of acute cervical spine injuries has been part of standard practice in the trauma setting for decades, aimed at preventing secondary injuries.ObjectivesTo review the recent evidence challenging the routine use of cervical collars, addressing the limited scientific support, associated risks, and guidelines for their use.MethodsA comprehensive literature review was conducted, analyzing recent studies and guidelines from authoritative bodies such as the American Association for Neurological Surgeons and the Congress of Neurological Surgeons. The review focused on the efficacy, risks, and recommendations regarding cervical collar use in acute cervical spine injuries.ResultsRecent evidence questions the routine use of cervical collars, highlighting limited scientific support and several associated risks, including pressure ulcers and decreased venous return. Cervical collars may also be contraindicated in individuals with abnormal spinal structures, such as those with Ankylosing Spondylitis. The efficacy of cervical collars is debated, particularly concerning undiagnosed spinal fractures, where delayed diagnosis can result in permanent injuries. Despite these risks, cervical collars may be beneficial in low‐resource areas and when used effectively with early clearance post‐injury. Current guidelines recommend immobilizing patients suspected of cervical spine injury but stress the importance of proper evaluation of the need for immobilization. Recent guidelines advocate for spinal motion restriction over traditional immobilization, emphasizing the need for better risk assessment and implementation strategies.Conclusions/Clinical ImportanceRe‐evaluating the routine use of cervical collars is crucial due to potential risks and limited supporting evidence, with a focus on individualized assessment and adherence to updated guidelines favoring spinal motion restriction.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Cervical collar use in spinal cord injury management

Kolli,

Medina,

DeYoung

et al. 2024

Clinical and Translational Dis

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“…There were 48.3% who had ICH that was not specified 44 . Although head injuries are the most common cause of trauma, spinal injuries are rare, with only 1% of pediatric patients being reported with a cervical spine fracture and 20% of those having spinal cord involvement 45 …”

Section: Discussionmentioning

confidence: 99%

“…44 Although head injuries are the most common cause of trauma, spinal injuries are rare, with only 1% of pediatric patients being reported with a cervical spine fracture and 20% of those having spinal cord involvement. 45 One currently controversial in-hospital treatment involves delivering an excess supply of oxygen. Naylor found that hyperoxia occurred in 22% of pediatric casualties, but no mortality difference was noted.…”

Section: Critical Carementioning

confidence: 99%

A scoping review of two decades of pediatric humanitarian care during wartime

Kocik

Borgman

April

et al. 2023

J Trauma Acute Care Surg

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Humanitarian care is a vital component of the wartime mission. Children comprise a significant proportion of casualties injured by explosives and penetrating weapons. Children face a variety of unique injury patterns in the combat setting as high-powered firearms and explosives are rarely seen in the civilian setting. We sought to perform a scoping review of pediatric research from the recent US-led wars in Afghanistan, and Iraq conflicts beginning in 2001. We used Google Scholar and PubMed to identify pediatric combat literature published between 2001 and 2022. We utilized the PRISMA-ScR Checklist to conduct this review. We identified 52 studies that met inclusion for this analysis—1 prospective observational study, 50 retrospective studies, and 1 case report. All the original research studies were retrospective in nature except for one. We identified one prospective study that was a post hoc subanalysis from an overall study assessing the success of prehospital lifesaving interventions. Most of the articles came from varying registries created by the United States and British militaries for the purposes of trauma performance improvement. The deployed health service support mission often includes treatment of pediatric trauma patients. The deployed health service support mission often includes treatment of pediatric trauma patients. We found that available literature from this setting is limited to retrospective studies except for one prospective study. Our findings suggest that pediatric humanitarian care was a significant source of medical resource consumption within both of the major wars. Further, many of the lessons learned have directly translated into changes in civilian pediatric trauma care practices highlighting the need for collaborative scientific developments between the military and civilian trauma programs. LEVEL OF EVIDENCE Systematic Review/Meta-Analyses; Level III.

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