Pediatric Cervical Spine Injuries
Anatomical considerations include:
- Head-to-body ratio significantly larger than adult patients
- High ligamentous laxity, underdeveloped paraspinous muscle development
- Increased force on fulcrum between axial spine and skull
Rare but dangerous: seen in less than 1% of pediatric blunt trauma
2011 PECARN Annals article lists 8 risk factors:
- High mechanism, diving injury, AMS, focal neurologic deficit, neck pain, torticollis, major torso injury, predisposing factors
- Remember that an elevated lactate does not equal sepsis
- Lactic acidosis spawns an extensive differential
- The Emergency Department is high risk for medical error
o Are you anchoring?
o Will your diagnostic inertia negatively affect your patient?
o Is premature closure limiting your differential?
- Remember to take your diagnostic pause