The Skeptics Guide to Emergency Medicine SGEM #467: Send me on my way…without Cervical Spine Imaging
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Feb 1, 2025 Join emergency medicine experts Tabitha Cheng, an EMS fellowship-trained physician, Julie Leonard, a pediatric EM attending and research leader, and Caleb Ward, a dedicated principal investigator in pediatrics. They dive into the latest advancements in cervical spine injury assessments in children, discussing innovative risk stratification systems and the PCARN decision rule. The conversation touches on the importance of minimizing radiation exposure and the evolving role of cervical collars in emergency care. They also explore collaborative approaches to enhancing pediatric care outcomes.
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Pediatric Car Accident Case
- An eight-year-old girl was brought to the ED after a car accident wearing a cervical collar placed by EMS.
- Despite appearing dazed and confused initially, she was found cooperative and without severe injury signs upon examination.
Pediatric C-Spine Injury Risks
- Pediatric cervical spine injuries are rare but potentially severe, mainly from blunt trauma.
- Due to children's sensitivity to radiation, minimizing unnecessary imaging is a priority in pediatric care.
PCARN Clinical Decision Rule
- The PCARN clinical decision rule identifies key risk factors for pediatric cervical spine injury.
- It shows high sensitivity and reduces unnecessary imaging in children after blunt trauma.