Division of Emergency Medicine, Department of Pediatrics, School of Medicine, Washington University in St. Louis, One Children's Place, Campus Box 8116, St Louis, MO 63110, USA.
Pediatr Clin North Am. 2013 Oct;60(5):1123-37. doi: 10.1016/j.pcl.2013.06.015. Epub 2013 Aug 20.
Once a child is determined to be at risk of having a cervical spine injury, clinicians must take appropriate precautions to avoid potential worsening of neurologic deficits. Occasionally these decisions are made in the absence of adequate cervical spine imaging when dealing with a child's unstable airway or other life-threatening injuries. Furthermore, clinicians have to make decisions regarding appropriate diagnostic testing to evaluate for potential injury. Decisions regarding testing should take into consideration the clinical presentation of the patient, aiming to order appropriate testing for those at risk and avoid unnecessary testing for those without signs of cervical spine injury.
一旦确定儿童有颈椎损伤的风险,临床医生必须采取适当的预防措施,以避免神经功能缺损的潜在恶化。在处理儿童不稳定气道或其他危及生命的损伤时,偶尔会在没有充分的颈椎影像学检查的情况下做出这些决定。此外,临床医生还必须做出关于适当诊断性检查的决定,以评估潜在的损伤。关于检查的决定应考虑患者的临床表现,旨在为有风险的患者安排适当的检查,避免对没有颈椎损伤迹象的患者进行不必要的检查。