Guideline document
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C-spine Clearance in Reliable Patient Guideline for Trauma (Cincinnati Children's)
Topic overview
Clinical guideline for cervical spine clearance in pediatric trauma patients at Cincinnati Children's Hospital. Defines criteria for reliable clinical examination and clearance without imaging in alert, neurologically intact children without distracting injuries or cervical tenderness. Provides age-specific radiographic protocols when clinical clearance criteria are not met.
Key Takeaways
- Clinical clearance requires normal mental status, no tenderness, pain-free range of motion, and no distracting injuries—no imaging needed if all met.
- Children <5 years need 2-view C-spine films (AP/lateral); children ≥5 years need 3-view films (AP/lateral/odontoid).
- Obtain neurosurgery consult for any abnormal neurologic findings: weakness, altered sensation, or autonomic dysfunction signs.
- Flexion/extension films are reserved for reliable patients with persistent midline tenderness after negative initial imaging.
- CT indicated for fractures or suspicious areas on plain films; MRI for neurologic deficits attributable to spinal cord injury.
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How to cite: GlobalCastMD. C-spine Clearance in Reliable Patient Guideline for Trauma (Cincinnati Children's). GlobalCastMD Medical Library. https://library.globalcastmd.com/guideline/1852
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