Abstract
Background
Pediatric trauma patients with cervical spine (CS) immobilization using a cervical
collar often require procedural sedation (PS) for radiologic imaging. The limited
ability to perform airway maneuvers while CS immobilized with a cervical collar is
a concern for emergency department (ED) staff providing PS.
Objective
To describe the use of PS and analgesia for radiologic imaging acquisition in pediatric
trauma patients with CS immobilization.
Methods
Retrospective medical record review of all trauma patients with CS immobilization
at a high-volume pediatric trauma center was performed. Patient demographics, imaging
modality, PS success, sedative and analgesia medications, and adverse events were
analyzed. Patients intubated prior to arrival to the ED were excluded.
Results
A total of 1417 patients with 1898 imaging encounters met our inclusion criteria.
A total of 398 patients required more than one radiographic imaging procedure. The
median age was 8 years (range 3.8–12.75 years). Computed tomography of the head was
used in 974 of the 1898 patients (51.3%). A total of 956 of the 1898 patients (50.4%)
required sedatives or analgesics for their radiographic imaging, with 875 (91.5%)
requiring a single sedative or analgesic agent, and 81 (8.5%) requiring more than
one medication. Airway obstruction was the most common adverse event, occurring in
5 of 956 patients (0.3%). All imaging procedures were successfully completed.
Conclusion
Only 50% of CS immobilized, nonintubated patients required a single sedative or analgesic
medication for their radiologic imaging. Procedural success was high, with few adverse
events.
Keywords
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Article info
Publication history
Published online: October 04, 2019
Accepted:
June 29,
2019
Received in revised form:
June 21,
2019
Received:
May 2,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
