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Related Experiment Videos

Cervical injury in head trauma.

G L Neifeld1, J G Keene, G Hevesy

  • 1University of Chicago Hospitals and Clinics, Department of Emergency Medicine, Illinois.

The Journal of Emergency Medicine
|May 1, 1988
PubMed
Summary

Patients with altered mental status, distracting injuries, or cervical spine pain require radiography after blunt trauma. Those who are alert with no neck tenderness can safely avoid imaging, reducing radiation exposure.

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Area of Science:

  • Emergency Medicine
  • Radiology
  • Trauma Surgery

Background:

  • Cervical spine radiography is standard for blunt trauma patients.
  • Unnecessary imaging exposes patients to radiation and increases costs.

Purpose of the Study:

  • To identify clinical criteria for excluding cervical spine radiography in blunt trauma patients.
  • To reduce unnecessary radiation exposure and healthcare costs.

Main Methods:

  • Prospective study at four Chicago-area hospitals.
  • Categorized adult patients with blunt head/neck trauma into four groups based on alertness, neck pain, and other injuries.
  • Compared fracture rates across groups.

Main Results:

  • Patients with altered mental status, intoxication, distracting injuries, or focal neurologic deficits had significantly higher fracture rates (21/387).

Related Experiment Videos

  • Patients reporting central neck pain or tenderness had significantly more fractures (7/237) than those without pain or with trapezius-only tenderness (0/236).

    • Conclusions:

    • Altered mental status, abnormal findings, distracting injuries, or cervical spine tenderness necessitate cervical spine radiographs.
    • Alert patients without neck pain or tenderness may be safely excluded from radiography.