Anya Aubuchon
Pronouns: she/her
Research Mentor(s): Heather Hartman
Research Mentor School/College/Department: Pediatric Surgery / Medicine
Program:
Authors: Anya Aubuchon, Heather Hartman, Peter Ehrlich
Session: Session 3: 11:00 am – 11: 50 am
Poster: 10
Abstract
Cervical spine collars (c-collars) are a vital tool for the immobilization and clinical management of pediatric trauma patients. There is a need for prompt clearance of patients without CSI to avoid iatrogenic complications, properly identify clinically significant injuries, and avoid unnecessary radiation. Current guidelines for c-collar clearance in pediatric patients call for the use of physical exam, conventional radiography, or multi-detector computed tomography (MDCT). Normal MDCT findings must be reproduced by physical exam or MRI for clearance of the collar. Given technological advances in MDCT scans, MRI is now unlikely to locate unstable cervical spine injuries when MDCT findings are normal. Given the need for prompt C-collar clearance and change in adult C-collar clearance guidelines, this study aims to determine whether an MRI is necessary for obtunded pediatric patients who have a concern for a possible neck injury, cannot be clinically cleared, and have a normal MDCT of their cervical spine. This study is a retrospective chart review analyzing the Michigan Medicine EMR of pediatric trauma patients admitted to Michigan Medicine between 1/1/2014-12/31/2022 with a cervical spine collar in place who underwent subsequent clearance or surgical intervention. The most common mechanism of injury found was motor vehicle crash. The majority of patients had a MDCT C-Spine completed. The majority of patients did not have a MRI C-Spine completed. The study is ongoing; therefore, a concrete conclusion regarding whether an MRI is necessary for obtunded pediatric patients has not yet been reached. However, initial review shows that MDCT imaging is sufficient to determine c-spine clearance without the need for further MRI imaging in an obtunded patient.
