Journal article
Errors in cervical spine immobilization during pediatric trauma evaluation
The Journal of surgical research, v 228
Aug 2018
PMID: 29907202
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The purpose of this study was to identify factors during trauma evaluation that increase the likelihood of errors in cervical spine immobilization (‘lapses’).
Multivariate analysis was used to identify the associations between patient characteristics, event features, and tasks performed in proximity to the head and neck and the occurrence and duration of a lapse in maintaining cervical spine immobilization during 56 pediatric trauma evaluations.
Lapses in cervical spine immobilization occurred in 71.4% of patients (n = 40), with an average of 1.2 ± 1.3 lapses per patient. Head and neck tasks classified as oxygen manipulation occurred an average of 12.2 ± 9.7 times per patient, whereas those related to neck examination and cervical collar manipulation occurred an average of 2.7 ± 1.7 and 2.1 ± 1.2 times per patient, respectively. More oxygen-related tasks were performed among patients who had than those who did not have a lapse (27.3 ± 16.5 versus 11.5 ± 8.0 tasks, P = 0.001). Patients who had cervical collar placement or manipulation had a two-fold higher risk of a lapse than those who did not have these tasks performed (OR 1.92, 95% CI 0.56, 3.28, P = 0.006). More lapses occurred during evaluations on the weekend (P = 0.01), when more tasks related to supplemental oxygen manipulation were performed (P = 0.02) and when more tasks associated with cervical collar management were performed (P < 0.001).
Errors in cervical spine immobilization were frequently observed during the initial evaluation of injured children. Strategies to reduce these errors should target approaches to head and neck management during the primary and secondary phases of trauma evaluation.
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Details
- Title
- Errors in cervical spine immobilization during pediatric trauma evaluation
- Creators
- Omar Z Ahmed - Division of Trauma and Burn Surgery, Department of General and Thoracic Surgery, Children's National Medical Center, Washington, Dist. of ColumbiaRachel B Webman - Division of Trauma and Burn Surgery, Department of General and Thoracic Surgery, Children's National Medical Center, Washington, Dist. of ColumbiaPuja D Sheth - Division of Trauma and Burn Surgery, Department of General and Thoracic Surgery, Children's National Medical Center, Washington, Dist. of ColumbiaJonah I Donnenfield - Division of Trauma and Burn Surgery, Department of General and Thoracic Surgery, Children's National Medical Center, Washington, Dist. of ColumbiaJaeWon Yang - Division of Trauma and Burn Surgery, Department of General and Thoracic Surgery, Children's National Medical Center, Washington, Dist. of ColumbiaAleksandra Sarcevic - College of Computing and Informatics, Drexel University, Philadelphia, PennsylvaniaIvan Marsic - Department of Electrical and Computer Engineering, Rutgers University, Piscataway, New JerseyRandall S Burd - Division of Trauma and Burn Surgery, Department of General and Thoracic Surgery, Children's National Medical Center, Washington, Dist. of Columbia
- Publication Details
- The Journal of surgical research, v 228
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Information Science
- Web of Science ID
- WOS:000436499700020
- Scopus ID
- 2-s2.0-85045062318
- Other Identifier
- 991014878648104721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Surgery