Paper Chase 4 - CT Screening for Pediatric Neck Injury

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Nurses Edition Commentary

Mizuho Morrison, DO, Lisa Chavez, RN, and Kathy Garvin, RN
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Ryan P. -

On this episode, they state that there is no consensus statement or recommentation from the EAST group, but this is incorrect. The 2010 EAST Guidelines for Blunt Cerebrovascular Injury (https://www.east.org/resources/treatment-guidelines/blunt-cerebrovascular-injury) do have a recommendation for imaging with seat belt sign of the neck: "An isolated cervical seat belt sign without other risk factors and normal physical examination has failed to be identified as an independent risk factor in two retrospective studies and should not be used as the sole criteria to stratify patients for screening."

Neil L. -

So a disease that may only occur 1 in 100 with a study of only 42 children with a seat belt sign. Is it no wonder there were no positive scans?? Considering that this is a rare disease but can cause a catastrophic consequences to a young population I do not think we can conclude if a child has a seat belt sign we don't need to scan. Stay vigilant.

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