Evidence map›Paper›PMID 31435734›Full record

ArticlePediatric surgery international2020

Implementation of a pediatric trauma cervical spine clearance pathway.

Natalie C Luehmann, Jacquelyn M Pastewski, Jennifer A Cirino, Ameer Al-Hadidi, Alexander M DeMare, Thomas W Riggs, Nathan M Novotny, Begum Akay

Abstract read
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In one paragraph

Article in Pediatric surgery international, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Natalie C LuehmannDepartment of Surgery, Beaumont Health, Royal Oak, MI, USA.
Jacquelyn M PastewskiDepartment of Surgery, Beaumont Health, Royal Oak, MI, USA.
Jennifer A CirinoDepartment of Surgery, Beaumont Health, Royal Oak, MI, USA.
Ameer Al-HadidiDepartment of Surgery, Beaumont Health, Royal Oak, MI, USA.
Alexander M DeMareDepartment of Surgery, Beaumont Health, Royal Oak, MI, USA.
Thomas W RiggsStatistics, Obstetrics and Gynecology, American College of Obstetricians and Gynecologists, Washington DC, USA.
Nathan M NovotnyDepartment of Pediatric Surgery, Beaumont Children's, Beaumont Health, 3535 West 13 Mile Road, Suite 307, Royal Oak, MI, 48073, USA.
Begum AkayDepartment of Pediatric Surgery, Beaumont Children's, Beaumont Health, 3535 West 13 Mile Road, Suite 307, Royal Oak, MI, 48073, USA. begum.akay@beaumont.org.ORCID http://orcid.org/0000-0003-1215-0359

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePediatric cervical spine injuries are rare events. Missed injuries must be weighed against radiation exposure and excess resource utilization in a young population. A universal pediatric cervical spine clearance algorithm does not exist. The study objective is to determine if care improved after the implementation of a standardized cervical spine clearance pathway by evaluating imaging rates, length of stay, speciality consultation, and injury detection.

methodsA multidisciplinary group reviewed relevant literature to develop an algorithm for cervical spine clearance in pediatric trauma patients. We reviewed patient charts 15 months before and after implementation. Categorical comparisons were tested with Chi-square. A p value less than 0.05 was considered statistically significant.

resultsThe pre- and post-implementation groups were homogenous when comparing demographics, mechanism and severity of injury. Using the cervical spine clearance pathway, patients received fewer plain cervical spine radiographs (34% vs 16%), fewer spine speciality consults (28% vs 13%), and more patients were cleared clinically (44% vs 62%) (p < 0.05). There were 2 (1.7%) documented injuries in the pre-implementation group and 3 (3%) documented injuries in the post-implementation group. There were no missed injuries.

conclusionsUse of a standardized pathway allows more patients' cervical spines to be cleared clinically and better utilizes resources without compromising patient care. LEVEL OF EVIDENCE: Level III. TYPE OF STUDY: Care Management Study.

Indexed as

Critical PathwaysAlgorithmsCervical VertebraeChildChild, PreschoolFemaleHumansInfantMaleMichiganProgram EvaluationProspective StudiesRadiographyReferral and ConsultationRisk AssessmentSpinal InjuriesPediatric cervical collar (c-collar)Pediatric cervical spine clearance pathway (CSCP)Pediatric cervical spine (c-spine) clearancePediatric cervical spine (c-spine) injury

Identifiers

PMID31435734

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.