Pediatric Cervical Spine Clearance and Immobilization Practice Among Prehospital Emergency Medical Providers

Abstract

Objectives: Pediatric cervical spine injuries are rare but potentially life threatening. Although published guidelines for assessment of such injuries exist, there is less uniformity in its implementation in out-of-hospital settings. Our purpose was to assess the knowledge and practice patterns for pediatric cervical spine immobilization among prehospital emergency medical services (EMS) providers in Arizona. Methods:A cross-sectional web-based survey was conducted (October-December 2018), using an electronic mailing list of certified EMS providers (ground and air) in Arizona. A 20-question structured web-based survey was developed and deployed.Results: One hundred eight EMS stations were contacted with the survey.Sixty-eight providers responded; majority were emergency medical paramedics (73.1%). Most of the stations surveyed did not have a pediatric trauma center (66.2%). When treating children younger than 3 years, half of the respondents stated they did not know of a specific cervical spine clearance criterion; 59.3% felt that cervical spine immobilization was required "sometimes," and 40.0% were unaware of the state's EMS pediatric cervical spine clearance algorithm; 93.9% of EMS providers felt that an age-based algorithm for cervical spine clearance in children would be useful. Conclusions:In this statewide survey involving prehospital EMS providers, we found that pediatric cervical spine clearance and immobilization practices, even within a specific geographic location, remain inconsistent.

Adaptation and validation of a pediatric simulator to study the movement of the cervical spine

“…The management of traumatic spinal cord injury cases in pediatrics is controversial, similar to that in adults [17,[25][26][27][28]. Survey results, such as those by Khetarpal et al [29], conclude that even within the same state, recommendations for spinal clearance and pediatric immobilization are discrepant. In 2022, Nolte et al [30] developed a new and interesting Emergency Medicine Spinal Immobilization Protocol for pediatric trauma patients.…”

Afflux massif de victimes pédiatriques

“…Comme décrit précédemment, l’enfant est à fort risque de lésions crâniennes, mais aussi rachidiennes et notamment cervicales. La mise en place d’un collier cervical en complément de l’examen clinique neurologique est essentielle [33] . D’autre part, la lutte contre l’hypothermie est un élément fondamental de la prise en charge initiale.…”