Paper Chase 2 – Pediatric C-Spine Injuries

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Nurses Edition Commentary

Mizuho Spangler, DO, Lisa Chavez, RN, and Kathy Garvin, RN
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Sean G., M.D. -

Im sorry but I love these studies that tell us that if a childs neck is not injured(they are A and Ox 4, no neck pain, no spinal tenderness no focal neuro findings) we do not need to image them....are there really doctors out there that image these pts? I mean if so why just the neck? Why not image all the body parts that are not injured?

Matt H. -

This study has some significant flaws that were not mentioned in the episode. First, it should be noted the methods section of this paper is approximately 100 words long. 100 WORDS!!! The title "Absence of Clinical Findings Reliably Excludes Unstable Cervical Spine Injuries in Children 5 years and Younger" is not justified. The methods do not clearly describe how the outcomes were identified, which specific injuries they searched for, or really what they defined as a cervical spine injury. Without knowing the authors definition of cervical spine injury we cannot apply the evidence from this paper. We do not know anything about the data quality or how the chart review/registry review was performed. Though this paper is provocative, it does not seem to deserve the credit given by the EMRAP team and should probably not be a practice changer for the listeners.

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