Ped C Spine algo v1

  • Reliable patient?
    • verbal
    • Developmentally normal
    • GCS 15
    • Not intoxicated
    • Ambulatory
  • yes
    • Apply clinical criteria
      • No medicine C-spine tenderness
      • Not intoxicated
      • No focal neurological deficit
      • Normal mental status
      • No distracting injury
      • No high risk mechanism
      • No predisposing condition
      • No torticollis
    • cleared
      • Remove C-Collar
    • unable to clear
  • no
    • Radiographic evaluation for bony injury (consider options below)
      • options
        • Head CT wit hhigh C-Spine
          • Age < 8
          • if head CT otherwise indicated
        • X-Ray C-Spine
          • Low risk
          • Able to obtain adequate films
        • CT C-Spine
          • High risk
          • Unable to obtain adequate X-rays
      • injury detected
        • yes
          • Neurosurgical consultation
        • no
          • Evaluate for ligamentous injury (Slide 2)

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