Development and Testing of a Pediatric Cervical Spine Injury Risk Assessment Tool

Description

Cervical spine injuries (CSI) are serious, but rare events in children. Spinal precautions (rigid cervical collar and immobilization on a longboard) in the prehospital setting may be beneficial for children with CSI, but are poorly studied. In contrast, spinal precautions for pediatric trauma patients without CSI are common and may be associated with harm. Spinal precautions result in well-documented adverse physical and physiological sequelae. Of substantial concern is that the mere presence of prehospital spinal precautions may lead to a cascade of events that results in the increased use of inappropriate radiographic testing in the emergency department (ED) to evaluate children for CSI and thus an unnecessary, increased exposure to ionizing radiation and lifetime risk of cancer. Most children who receive spinal precautions and/or are imaged for potential CSI, and particularly those imaged with computed tomography (CT), are exposed to potential harm with no demonstrable benefit. Therefore, there is an urgent need to develop a Pediatric CSI Risk Assessment Tool that can be used in the prehospital and ED settings to reduce the number of children who receive prehospital spinal precautions inappropriately and are imaged unnecessarily while identifying all children who are truly at risk for CSI.

Conditions

Cervical Spine Injury

Study Overview

Study Details

Study overview

Cervical spine injuries (CSI) are serious, but rare events in children. Spinal precautions (rigid cervical collar and immobilization on a longboard) in the prehospital setting may be beneficial for children with CSI, but are poorly studied. In contrast, spinal precautions for pediatric trauma patients without CSI are common and may be associated with harm. Spinal precautions result in well-documented adverse physical and physiological sequelae. Of substantial concern is that the mere presence of prehospital spinal precautions may lead to a cascade of events that results in the increased use of inappropriate radiographic testing in the emergency department (ED) to evaluate children for CSI and thus an unnecessary, increased exposure to ionizing radiation and lifetime risk of cancer. Most children who receive spinal precautions and/or are imaged for potential CSI, and particularly those imaged with computed tomography (CT), are exposed to potential harm with no demonstrable benefit. Therefore, there is an urgent need to develop a Pediatric CSI Risk Assessment Tool that can be used in the prehospital and ED settings to reduce the number of children who receive prehospital spinal precautions inappropriately and are imaged unnecessarily while identifying all children who are truly at risk for CSI.

Development and Testing of a Pediatric Cervical Spine Injury Risk Assessment Tool

Development and Testing of a Pediatric Cervical Spine Injury Risk Assessment Tool

Condition
Cervical Spine Injury
Intervention / Treatment

-

Contacts and Locations

Los Angeles

Children's Hospital Los Angeles, Los Angeles, California, United States, 90027

Oakland

UCSF Benioff Children's Hospital, Oakland, California, United States, 94609

Sacramento

Children's Hospital UC Davis Health, Sacramento, California, United States, 95817

Denver

Children's Hospital Colorado, Denver, Colorado, United States, 80045

Washington

Children's National Medical Center, Washington, District of Columbia, United States, 20310

Atlanta

Children's Healthcare of Atlanta, Atlanta, Georgia, United States, 30329

Boston

Boston Children's Hospital, Boston, Massachusetts, United States, 02115

Ann Arbor

CS Mott Children's Hospital, Ann Arbor, Michigan, United States, 48109

Saint Louis

Washington University School of Medicine in St. Louis, Saint Louis, Missouri, United States, 63130

Cincinnati

Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States, 45229

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * Age 0-17 years
  • * Known or suspected exposure to blunt trauma
  • * Undergoing trauma team evaluation
  • * Transported from the scene to participating facility by EMS
  • * Undergoing cervical spine imaging at participating facility
  • * Transferred to participating facility with cervical spine imaging
  • * Exposed to solely penetrating trauma (e.g. a gunshot or stab wound)

Ages Eligible for Study

to 18 Years

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

Julie Leonard,

Study Record Dates

2026-09-01