title: Implementation of pediatric cervical spine clearance guidelines at a combined trauma center: Twelve-month impact.
abstract: BACKGROUND
  Pediatric cervical spine clearance guidelines should reduce computed tomography (CT) usage in combined pediatric and adult trauma centers biased by adult CT clearance.
  
  
  METHODS
  Cervical spine clearance under age 15 years was compared 12 months before (128 patients) and after (105 patients) guideline implementation, emphasizing National Emergency X-Radiography Utilization Study (NEXUS) criteria when appropriate.
  
  
  RESULTS
  CT scans in patients clearable by NEXUS criteria decreased 23% (p = 0.01) and decreased by 16% in cases where radiography other than CT was indicated by guidelines (p = 0.01).
  
  
  CONCLUSIONS
  Guideline implementation can have an immediate effect in decreasing pediatric cervical spine CT usage and should improve across time.
  
  
  METHODS
  Care management study, level IV.
authors.affiliation: From the Division of Pediatric Surgery (S.F.R., R.M., D.P., J.H.) and Department of Surgery (L.W.), School of Medicine (M.P., R.M., K.B.), and Children's Trauma Center, Children's Hospital of Richmond (J.H.H.), Virginia Commonwealth University Health System, Richmond, Virginia.
authors.forename: Shannon F
authors.initials: SF
authors.lastname: Rosati
authors.forename: Rami
authors.initials: R
authors.lastname: Maarouf
authors.forename: Luke
authors.initials: L
authors.lastname: Wolfe
authors.forename: Dan
authors.initials: D
authors.lastname: Parrish
authors.forename: Michael
authors.initials: M
authors.lastname: Poppe
authors.forename: Robin
authors.initials: R
authors.lastname: Manners
authors.forename: Karen
authors.initials: K
authors.lastname: Brown
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Haynes
mesh_terms: D000293:Adolescent; D002574:Cervical Vertebrae / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D012189:Retrospective Studies; D013124:Spinal Injuries / Q000000981:diagnostic imaging*; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014193:Trauma Centers