I would appreciate any responses to the following questions regarding
workup of the closed head injured pediatric patient. The population of
patients that I am referring to would typically be a child in an MVA with
an isolated CHI, without clinical evidence of spinal cord injury, severe
enough to require mechanical ventilator support.
1. Are you able to clear the C-spine after intubation radiologically, or
are pts kept in neck immobilization until after extubation and
flexion-extension films can be obtained? If c/s clearance cannot be
obtained, what radiographic studies are performed in the ED prior to
disposition to ICU?
2. What is the typical radiologic imaging workup for the entire spine in
an intubated pt. with a CHI (one may have to disinguish between those
getting an ICP monitor and those who are not)
3. Are there subsets of patients who do not get an entire spinal series?
4. What is the average LOS in ED for these patients?
Thanks in advance for any responses!
Anne Morton, MD
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