A study published in the March 2014 edition of Spine examines protocol for cervical spine clearance in level 1 trauma centers.
The researchers connected with 191 trauma centers in the United States and reviewed available protocol for four different scenarios:
• Clearing the asymptomatic patient
• Imaging used in patients not amenable to clinical clearance
• Management strategies for persistent neck pain patients with negative CT scans
• Patients who are obtunded
The researchers received an 87 percent response rate and found that cervical spine clearance protocols existed at 57 percent of the institutions. Additionally, the National Emergency X-Radiography Utilization Study criteria for clearing asymptomatic patients are recommended in 89 percent of the protocols.
Around 60 percent of the protocols used CT scans as the first line of imaging and in patients with persistent neck pain with negative CT scan flexion-extension plain radiographs were the next step in 30 percent of the institutions for clearance. For obtunded patients, a CT scan followed by MRI was the protocol in 31 percent of the institutions for clearance.
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