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Pediatric trauma population spine immobilization during resuscitation: A call for improved guidelines.

Authors :
Breeding T
Nasef H
Amin Q
Smith C
Elkbuli A
Source :
The American journal of emergency medicine [Am J Emerg Med] 2024 Feb; Vol. 76, pp. 150-154. Date of Electronic Publication: 2023 Dec 03.
Publication Year :
2024

Abstract

Introduction: This review aims to evaluate current practices regarding spine immobilization in pediatric trauma patients to evaluate their efficacy, reliability, and impact on clinical outcomes to guide future research and improved evidence-based practice guidelines.<br />Methods: PubMed, ProQuest, Embase, Google Scholar, and Cochrane were queried for studies pertaining to spinal immobilization practices in pediatric trauma patients. Articles were separated into studies that explored both the efficacy and clinical outcomes of spine immobilization. Outcomes evaluated included frequency of spinal imaging, self-reported pain level, emergency department length of stay (ED-LOS), and ED disposition.<br />Results: Six articles were included, with two studies examining clinical outcomes and 4 studies evaluating the efficacy and reliability of immobilization techniques. Immobilized children were significantly more likely to undergo cervical spine imaging (OR 8.2, p < 0.001), be admitted to the floor (OR 4.0, p < 0.001), be taken to the ICU or OR (OR 5.3, p < 0.05) and reported a higher median pain score. Older children were significantly more likely to be immobilized. No immobilization techniques consistently achieved neutral positioning, and patients most often presented in a flexed position. Lapses in immobilization occurred in 71.4% of patients.<br />Conclusion: Immobilized pediatric patients underwent more cervical radiographs, and had higher hospital and ICU admission rates, and higher mean pain scores than those without immobilization. Immobilization was inconsistent across age groups and often resulted in lapses and improper alignment. Further research is needed to identify the most appropriate immobilization techniques for pediatric patients and when to use them.<br />Competing Interests: Declaration of Competing Interest Authors declare no competing interests.<br /> (Copyright © 2023 Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1532-8171
Volume :
76
Database :
MEDLINE
Journal :
The American journal of emergency medicine
Publication Type :
Academic Journal
Accession number :
38086180
Full Text :
https://doi.org/10.1016/j.ajem.2023.11.055