The Presence of Nonthoracic Distracting Injuries Does Not Affect the Initial Clinical Examination of the Cervical Spine in Evaluable Blunt Trauma Patients: A Prospective Observational Study

2011 ◽  
Vol 71 (3) ◽  
pp. 528-532 ◽  
Author(s):  
Agathoklis Konstantinidis ◽  
David Plurad ◽  
Galinos Barmparas ◽  
Kenji Inaba ◽  
Lydia Lam ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Observational Study ◽  
Blunt Trauma ◽  
Clinical Examination ◽  
Prospective Observational Study ◽  
Trauma Patients

Prehospital Clinical Clearance of the Cervical Spine: A Prospective Study

2013 ◽  
Vol 79 (11) ◽  
pp. 1213-1217 ◽  
Author(s):  
Richard P. Gonzalez ◽  
Glenn R. Cummings ◽  
Jeremy A. Baker ◽  
Amin M. Frotan ◽  
Jon D. Simmons ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Prospective Study ◽  
Blunt Trauma ◽  
Clinical Examination ◽  
Medical Center ◽  
Fire Department ◽  
Prehospital Setting ◽  
Patient Comfort ◽  
Spine Injury ◽  
Trauma Patients

Physician clinical clearance of the cervical spine after blunt trauma is practiced in many trauma centers. Prehospital clinical clearance of the cervical spine (c-spine) performed by emergency medical services (EMS) personnel can decrease cost, improve patient comfort, decrease complications, and decrease prehospital time. The purpose of this study was to assess whether EMS personnel can effectively clinically clear the c-spine of injury in the prehospital setting. All paramedics from a single urban fire department were trained in clinical clearance of the c-spine. During the 14-month period from January 2008 through March 2009, clinical examination of the c-spine was performed by paramedics on blunt trauma patients in the prehospital setting. Paramedics immobilized the c-spine and delivered the patients to the University of South Alabama Medical Center. After trauma center arrival, paramedics documented their clinical examination of the c-spine in a computerized data collection form. Paramedic clinical findings were compared with trauma surgeon clinical examination findings and computed tomographic findings of the c-spine. All patients had prehospital Glasgow Coma Score 14 or greater. Patients were not excluded for distracting injuries. One hundred ninety-three blunt trauma patients were entered. Sixty-five (34%) c-spines were clinically cleared by EMS. There were no known missed injuries in this patient group. Eight (6%) patients who were not clinically cleared by EMS were diagnosed with c-spine injury. Trauma surgeons clinically cleared 135 (70%) of the patients with no known missed injury. EMS personnel in the prehospital setting may reliably and effectively perform clinical clearance of the c-spine. Further prospective study for prehospital c-spine clinical clearance is warranted.

scholarly journals Derivation and Validation of Two Decision Instruments for Selective Chest CT in Blunt Trauma: A Multicenter Prospective Observational Study (NEXUS Chest CT)

PLoS Medicine ◽  
2015 ◽  
Vol 12 (10) ◽  
pp. e1001883 ◽  
Author(s):  
Robert M. Rodriguez ◽  
Mark I. Langdorf ◽  
Daniel Nishijima ◽  
Brigitte M. Baumann ◽  
Gregory W. Hendey ◽  
...  
Keyword(s):  
Observational Study ◽  
Blunt Trauma ◽  
Prospective Observational Study ◽  
Chest Ct ◽  
Multicenter Prospective Observational Study

40-Slice Multidetector CT: Is MRI Still Necessary for Cervical Spine Clearance after Blunt Trauma?

2010 ◽  
Vol 76 (2) ◽  
pp. 157-163 ◽  
Author(s):  
Jay Menaker ◽  
Deborah M. Stein ◽  
Allan S. Philp ◽  
Thomas M. Scalea
Keyword(s):  
Cervical Spine ◽  
Blunt Trauma ◽  
Trauma Registry ◽  
Clinical Symptoms ◽  
Multidetector Ct ◽  
Trauma Patients ◽  
Mri Findings ◽  
Persistent Symptoms ◽  
Operative Repair ◽  
Ct Technology

We have recently demonstrated that 16-slice multidetector CT (MDCT) is insufficient for cervical spine (CS) clearance in patients with unreliable examinations after blunt trauma. The purpose of this study was to determine if a negative CS CT using 40-slice MDCT is sufficient for ruling out CS injury in unreliable blunt trauma patients or if MRI remains necessary for definitive clearance. In addition, we sought to elucidate the frequency by which MRI alters treatment in patients with a negative CS CT who have a reliable examination with persistent clinical symptoms. The trauma registry was used to identify all patients with blunt trauma who had a negative CS CT on admission using 40-slice MDCT and a subsequent CS MRI during their hospitalization from July 2006 to July 2007. Two hundred thirteen patients were identified. Overall, 24.4 per cent patients had abnormal MRIs. Fifteen required operative repair; 23 required extended cervical collar; and 14 had collars removed. A total of 8.3 per cent of patients with an unreliable examination and 25.6 per cent of reliable patients had management changed based on MRI findings. Overall, MRI changed clinical practice in 17.8 per cent of all patients. Despite newer 40-slice CT technology, MRI continues to be necessary for CS clearance in patients with unreliable examinations or persistent symptoms.

Assessing Cervical Spine Stability in Obtunded Blunt Trauma Patients: Review of Medical Literature

Radiology ◽  
2005 ◽  
Vol 234 (3) ◽  
pp. 733-739 ◽  
Author(s):  
Clint W. Sliker ◽  
Stuart E. Mirvis ◽  
Kathirkamanathan Shanmuganathan
Keyword(s):  
Cervical Spine ◽  
Blunt Trauma ◽  
Medical Literature ◽  
Trauma Patients ◽  
Spine Stability

scholarly journals Impact of MRI on changing management of the cervical spine in blunt trauma patients with a ‘negative’ CT scan

2016 ◽  
Vol 1 (1) ◽  
pp. e000016 ◽  
Author(s):  
Mohamed A Mohamed ◽  
Karl D Majeske ◽  
Gul Sachwani-Daswani ◽  
Daniel Coffey ◽  
Karim M Elghawy ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Ct Scan ◽  
Blunt Trauma ◽  
Trauma Patients
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