Evidence map›Paper›PMID 39900888›Full record

ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2025

Reducing radiation exposure in pediatric cervical spine imaging for trauma: a multi-disciplinary quality improvement initiative.

Nina Yu, Jonathan Emerson Kohler, Kendra Grether-Jones, Maureen Murphy, Marike Zwienenberg

Abstract read
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Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Nina YuUniversity of California, Davis, School of Medicine, Sacramento, CA, 95817, USA.ORCID http://orcid.org/0000-0002-2387-2093
Jonathan Emerson KohlerDepartment of Surgery, University of California, Davis, Sacramento, CA, 95817, USA.
Kendra Grether-JonesDepartment of Emergency Medicine, University of California, Davis, Sacramento, CA, 95817, USA.
Maureen MurphyDepartment of Surgery, University of California, Davis, Sacramento, CA, 95817, USA.
Marike ZwienenbergDepartment of Neurological Surgery, University of California, Davis, 4860 Y St., Suite 3740, Sacramento, CA, 95817, USA. mzwien@ucdavis.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePediatric cervical spine injury (PCSI) can result in devastating neurologic disability. While computed tomography (CT) imaging is both sensitive and specific in detecting clinically significant injuries, indiscriminate utilization can lead to excessive ionizing radiation exposure. A routine institutional audit revealed CTs were inappropriately obtained 54% of the time. This study evaluates the effects of an updated protocol to reduce radiation exposure in pediatric trauma patients.

methodsData were retrospectively analyzed from a pediatric level 1 trauma center from 2021 to 2022. The data were divided into two cohorts, pre-implementation (2021) and post-implementation (2022). Inclusion criteria were patients 0-14 years old with a Glasgow Coma Scale (GCS) ranging 9-15. Outside-hospital transfers were excluded. The primary study endpoints were guideline compliance and CT utilization.

resultsA total of 82 subjects were enrolled in this study. In 2021, there were 38 subjects (female/male 15/23, mean age 5.9 years old) with an average GCS of 13.6. In 2022, there were 44 subjects (female/male 19/25, mean age 5.2 years old) with an average GCS of 14.0. In 2021, the overall protocol adherence rate was 81.6%, and post-implementation in 2022, compliance was 93.2% (p = 0.109). Following implementation, the rate of inappropriate (protocol non-adherent CT) use decreased from 58.6 to 6.8% (p < 0.05).

conclusionsImplementation of a new evidence-based institutional protocol for PCSI was associated with improved adherence and reduction of unnecessary CT orders. Ongoing monitoring will help determine if these improvements are sustained.

Indexed as

Cervical VertebraeQuality ImprovementRadiation ExposureSpinal InjuriesTomography, X-Ray ComputedAdolescentChildChild, PreschoolFemaleGuideline AdherenceHumansInfantInfant, NewbornMaleRetrospective StudiesTrauma CentersImagingPediatricQuality improvementTrauma

Identifiers

PMID39900888
PMCPMC11790755

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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.