Cervical spine clearance protocols vary considerably

March 24, 2014
Cervical spine clearance protocols vary considerably

(HealthDay)—Cervical spine clearance protocols for level-1 trauma centers are highly variable, according to a study published in the March 1 issue of Spine.

Alexander A. Theologis, M.D., from the University of California-San Francisco, and colleagues contacted 191 U.S. level-1 trauma centers (response rate, 87 percent) and reviewed all available cervical spine clearance protocols. Four scenarios were evaluated for each protocol: clearing asymptomatic ; imaging for patients who are not amenable to clinical clearance; management strategies for patients with persistent neck pain and negative computed tomographic (CT) scan; and those who are obtunded.

The researchers found that 57 percent of institutions had cervical spine clearance protocols. In 89 percent of protocols, the National Emergency X-Radiography Utilization Study criteria were recommended to clear . CT scans were used as first-line imaging in 60 percent of protocols. Flexion-extension plain radiographs were the most common (30 percent) next step for clearance in patients with persistent neck pain and negative CT scan. A CT scan followed by magnetic resonance imaging was the most common method (31 percent) of clearance in obtunded patients. Dynamic flexion-extension views were recommended for patients who are obtunded in 8 percent of protocols, despite being contraindicated.

"These protocols are highly variable and standardization and utilization of these protocols should be encouraged in all to prevent missed injuries and neurological catastrophes," the authors write.

Relevant financial activities outside the submitted work were disclosed: board membership, expert testimony, consultant, royalties, patents, and stock options.

Explore further: Chest complaints more costly in obese patients

More information: Abstract
Full Text (subscription or payment may be required)

Related Stories

Chest complaints more costly in obese patients

March 8, 2014

(HealthDay)—Higher body mass index (BMI) is associated with increased cost of care and longer hospital stays for patients who present to the emergency department with chest pain and dyspnea, according to research published ...

Top five low-value actions ID'd in emergency medicine

February 19, 2014

(HealthDay)—The top five tests, treatments, and/or disposition decisions that are of little value in emergency medicine have been identified, according to research published online Feb. 17 in JAMA: Internal Medicine.

Surgery consultation common after MRI of the spine

January 2, 2013

(HealthDay)—Almost half of patients whose primary care physicians recommend a lumbosacral or cervical spine magnetic resonance imaging (MRI) scan go on to receive a surgical consultation, but few end up undergoing spinal ...

Prehospital stroke alerts speed door-to-CT times

March 12, 2014

(HealthDay)—Emergency medical services (EMS) prenotification regarding the arrival of patients who have had a stroke allows patients to bypass the emergency department and undergo computed tomography (CT) in a timely manner, ...

Recommended for you

Scientists 3-D print human of the future

December 29, 2016

Interactive 3-D models of human joints, showing how common medical complaints have arisen and how we are likely to evolve in the future, have been created at Oxford University.

An eye on young specialists' success

December 5, 2016

Graduates from several medical and surgical specialties are having difficulty securing practice opportunities, especially in specialties dependent upon limited resources, according to new research from Queen's ophthalmologist ...

'Halo' effect common after lasik eye surgery

December 3, 2016

(HealthDay)—Nine out of 10 Lasik laser eye surgery patients report satisfaction afterwards. But a sizable percentage experience new visual disturbances—like seeing halos around lights—up to six months after the procedure, ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.