![]() Pediatric patients ages 12 and younger are managed by the pediatric surgery trauma team, and approximately 200 pediatric trauma admissions occur yearly. Pediatric specialty services offered include pediatric surgery, pediatric emergency medicine, pediatric orthopaedic surgery, pediatric neurosurgery, and pediatric radiology, among others. Pediatric patients were generally evaluated with the same workup used in adult patients and, quite often, a CT scan was obtained.īeaumont Children’s is a Level 2 pediatric trauma center and is housed on the campus of Beaumont Hospital Royal Oak, a 1,100-bed tertiary care and Level 1 adult trauma center. The decision for imaging often depended on the practices of the physician(s) seeing the patient rather than predefined clinical criteria and risk stratification. ![]() As a result, patients experienced variations in care. 6-8 The problemīeaumont Children’s Hospital/Beaumont Health, Royal Oak, MI, lacked any guidelines on c-spine clearance. Separate pathways for clearance of the pediatric c-spine have been found to be effective and reduce radiation exposure. An established algorithm for c-spine evaluation can help balance these conflicting ideals in clinical decision making. 5 Injuries cannot be missed, but patients at low risk for injury should not be subject to unnecessary radiation exposure early in their lives. Aggressive imaging in the pediatric patient population can be costly and may expose children to large amounts of radiation and, therefore, potential future malignancies. 4 Until recently, the c-spine workup at many institutions involved obtaining multiple c-spine films and often a complete c-spine computed tomography (CT) scan. 1-3 Although the incidence, characteristics, and severity of c-spine injuries differ between adult and pediatric populations, pediatric patients are generally subjected to the same traumatic workup of their c-spine as adult trauma patients. Pediatric cervical spine (c-spine) injuries are rare events, with an incidence of approximately 1 to 2 percent and potentially devastating consequences.
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