Case COnference - Dr. King

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

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Sepsis Masquerade

-       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